mmm 


THE 


MEDICAL  PROFESSION 


ANCIENT    TIMES. 


AN  ANNIVERSARY  DISCOURSE 


DELIVERED    BEFORE   THE 


'  NEW  YORK  ACADEMY  OF  MEDICINE, 


NOVEMBER  7.  18S5, 


J  O  H%    WATSON,    M  .   D 

SURGEON   TO   THE   NEAV  YORK   HOSPITAL. 


[published  by   order   of   the   academy.] 

♦ 


NEW    YORK: 
PRINTED  FOR  THE  ACADEMY  BY  BAKER  &  GODWIN, 

CORNER    NASSAU    AND    SPRUCE    STREETS. 


1856 


Entered  according  to  Act  of  Congress,  in  the  year  1856,  by 

JOHN   WATSON,   M.  D.,  J 

In  the  Clerk's  Office  of  the  District  Court  for  the  Southern  District  of  New  York.  "^ 

^ ^^ 


K 


Libraiy 

SI 
PREFACE 


In  the  preparation  of  tlie  following  discourse,  I 
liave  endeavored  to  trace  tlie  origin  and  progress 
of  medicine  among  tlie  ancients  in  as  succinct  a 
manner  as  possible  consistent  with  perspicuity ; 
and  at  the  same  time  to  omit  nothing  of  importance 
or  interest  in  relation  to  the  subject. 

Though  small,  the  work  is  the  result  of  no  incon- 
siderable research ;  much  of  which  might  have  been 
spared,  had  I  been  disposed  to  rely  simply  on  the 
historians.  But  as  my  investigations  were  under- 
taken for  my  own  gratification,  I  have,  as  far  as 
leisure  and  opportunity  would  permit,  drawn  the 
facts  and  opinions  here  embodied,  from  the  earliest 
authorities. 

But  while  resorting  to  the  ancients,  I  am  not 
indisposed  to  acknowledge  the  assistance  I  have 
received  from  modern  and  recent  writers.  With- 
out the  learned  researches  of  Le  Clerc,  Freind, 
Schulze,  and  Sprengel,  much  that  has  since  ap- 
peared on  the   history  of  medicine    might    never 


IV  PREFACE. 


have  seen  the  light.  The  works  of  these  authors, 
as  well  as  of  Barchusen,  Gcelicke,  Hamilton,  and 
Renouard  ;  the  ''  Bibliotheca  Scriptorum  Medicor- 
um"  of  Mangetus,  the  seven  volumes  of  Bio- 
graphie  Medicale  from  the  "  Dictionnaire  des  Sci- 
ences Medicales ;"  the  able  articles  on  medical  history 
by  Bostock  in  the  "  Cyclopaedia  of  Practical  Medi- 
cine," and  by  Bage  Delorme  in  the  "  Dictionnaire 
de  Medecine,"  not  to  speak  of  the  medical  articles  in 
the  several  dictionaries  of  classical  biography, — I 
have  consulted  on  all  occasions. 

My  researches  have  been  further  expedited  by 
Stanley's,  Tennemann's,  and  Bitter's  Histories  of 
Philosophy,  by  Taylor's  account  of  the  Ancient 
Mysteries,  by  Mosheim's  Ecclesiastical  History, 
Therwell's  Greece,  Gibbon's  Decline  and  Fall  of 
the  Boman  Empire,  Sharpe's  History  of  Egypt, 
Guizot's  Cours  d'Histoire,  and  by  the  Oxford 
Tables  of  Chronology.  The  recent  translations 
from  the  Greek  classics  published  by  Mr.  Bohn  and 
others,  I  have  put  under  extensive  contribution, 
particularly  the  works  of  Herodotus,  Thucydides, 
Xenophon,  Plato,  Aristotle,  Diogenes  Laertius,  Plu- 
tarch, Athenseus,  and  the  writings  of  the  emperor 
Julian,  as  well  as  the  ecclesiastical  histories  of 
Eusebius,  Socrates,  Theodoret,  and  Evagrius. 

The  medical  writers  of  antiquity,  from  Hippo- 
crates to  Paulus  ^gineta,  with  one  or  two  insignifi- 


PREFACE 


;ant  exceptions,  so  far  as  they  have  yet  appeared  in 
print,  as  well  as  the  other  works  of  reference  al- 
ready mentioned,  I  have  in  my  own  library.  From 
these  ancient  writers,  and  their  respective  commen- 
tators, I  have  drawn  without  restraint.  Among 
the  commentators  to  whom  I  am  most  indebted  are, 
Ackermann,  in  Kuhn's  editions  of  Hippocrates  and 
Galen ;  M.  Littre,  in  his  recent  and  elaborate  Intro- 
duction to  his  French  version  of  Hippocrates ;  Mr. 
Adams,  in  his  English  versions  of  Hippocrates  and 
Paulus  JEgineta;  Greive,  in  his  introduction  to 
Celsus  ;  Conrad  Amman,  in  his  preface  to  Cselius 
Aurelianus ;  the  numerous  commentators  whose 
names  are  associated  with  the  "  Medicinse  Artis  Prin- 
cipes  post  Hippocratem  et  Galenum,"  published 
under  the  auspices  of  Henric.  Stephanus ;  and  Coc- 
cius,  in  the  "  Grsecorum  Chirurgici  Libri  e  collectione 
Nicetse."  Much  also  bearing  upon  the  profession  I 
have  drawn  from  Aristotle's  treatise  ''  De  Animali- 
bus ; "  from  Vitruvius'  "  De  Architectura-;"  from  the 
agricultural  treatises  of  Cato,  Varro,  Columella,  and 
Palladius;  from  the  "  Mulo-medicina"  of  Vegetius; 
from  AjDicius,  "  De  Opsoniis ;"  and  from  the  writ- 
ings of  the  elder  Pliny. 

For  all  that  relates  to  the  laws  and  usages  of  the 
Koman  Empire  in  regard  to  the  profession,  I  have 
drawn  from  the  "  Corpus  Juris  Civilis  "  of  Justinian, 
1 


VI  PREFACE. 

excepting  one  or  two  enactments  from  the  Theodo- 
sian  Code  whicli  I  have  taken  on  other  authority. 

Led  on  by  the  attractive  nature  of  the  study,  I 
have  extended  my  researches  beyond  the  period  of 
Greek  and  Eoman  antiquity  ;  and  have  on  hand  the 
materials  for  a  somewhat  similar  account  of  the  pro- 
fession among  the  Arabs  of  the  East  and  West, 
among  the  Byzantine  and  Latin  schools,  and  the 
monastic  medical  institutions  of  the  middle  ages ; 
which  I  hope  on  some  favorable  occasion  also  to  pre- 
sent to  the  New  York  Academy  of  Medicine,  to 
whom  the  present  work  is  most  respectfully  in- 
scribed. 


TABLE  OF  CONTENTS. 


PAGE 

Preface,       .......         1 

Introductory  Remarks,  ....  9 


CHAPTER    I. 

THE    CONDITION    OF   MEDICINE    IN   THE    EARLIEST    ORGANIZATIONS  OF 

SOCIETY. 

Nations  in  which  the  art  of  medicine  was  unknown  as  a  distinct 

occupation,               .             .             .             .             ,  12 

The  first  practitioner  of  Rome,            .             .             .  .13 

The  Druids  of  Europe,      .             .             .             .             .  13 

The  Vaidhyas  of  India,  ^       .             .             .             .  .14 

The  Lamas  of  Central  Asia,   ,       .             .             .             .  14 

The  Tla-quill-aughs  of  Anierica,        .             .             .  .15 

The  Priests  of  Egypt,       .             .            .            .             .  16 

CHAPTER    II. 

THE    ORIGIN    OF    MEDICINE    AMONG   THE    GREEKS. 

1.  The  Gymnasia  and  their  course  of  Education,        .  .18 

2.  The  Schools  of  Philosophy,  ....  20 
The  School  of  Pythagoras  at  Crotona,  .  .  .20 
Democedes  of  Crotona,  .  .  .  .  21 
The  Academy  and  Lyceum,          .             .             .  .22 

3.  The  Temples  of  ^sculapius,  their  usages,  rules,  and  symbols,  25 
JEsculapius  and  his  descendants,  .  .  .29 
Other  Medical  Divinities,         ....  30 


Vlll  CONTENTS. 

PAOB 

4.  The  Periodeutae  or  Itinerant  Practitioners,  .  .       30 

Progress  of  the  Profession  in  Greece,  before  the  age  of  Pericles,     33 


CHAPTER    III. 

THE    ASCLEPIAD^. 

Their  modes  of  Initiation  similar  to  those  of  the  other  Mys- 
teries or  Secret  Associations  of  Greece,          .             .  34 
The  Eleusinian,  Dionjsian,  and  other  Mysteries,         .  .       35 
Their  three  degrees  or  stages  of  Advancement  similar  to  those 

of  the  early  universities  of  Europe,     ...  36 

Course  of  Training  among  the  Asclepiadse,     .             .  .36 

The  Ceremony  of  Coronation,       .             .             .             .  39 

The  Medical  Acquirements  of  the  Asclepiadse,            .  .       40 

Herodicus  of  Selymbria,                ....  41 

The  Policy  and  Ethics  of  the  Asclepiadse,       .             .  .42 

Their  Social  Rank,           .....  44 


CHAPTER    IV. 

HIPPOCRATES    AND    HIS    IMMEDIATE    SUCCESSORS. 

Personal  History  of  Hippocrates,        .             .             .  .45 

The  Hippocratic  Writings,            ....  48 

The  Doctrines  of  Hippocrates  and  of  his  followers,     .  .       52 

The  Schools  of  Cos  and  Coidos,    ....  5*7 

The  Plague  of  Athens,            .             .             .             .  .61 

The  Anatomical  and  Physiological  \news  of  Aristotle,        .  66 

The  Last  of  the  Asclepions  of  Cos  and  Cnidos,            .  .       12 


CHAPTER    V. 

PERGAMUS    AND    ALEXANDRIA. 

The  Asclepion  and  Library  of  Pergamus,  .  .  '74 

The  Founding  and  Institutions  of  Alexandria,  .  .       '74 


CONTENTS.  IX 

PAGB 

The  Temple  of  Serapis,  its  Library,  .  .  .  16 

The  Museum  ;  its  organization  and  courses  of  Instruction  ;  its 

Faculties,  .  .  .  .  .  .11 

The  Use  of  Papyrus  and  of  Parchment,    .  .  .  82 

Early  Libraries,         .  .  .  .  .  .       83 


CHAPTER    VI. 

THE    SCHOOL    OF    MEDICINE    AT    ALEXANDRIA. 

Herophilus,  Dissections  of  the  Human  Body,              .  .84 

Erasistratus,          .             .             .             .             .  .             85 

Writers  on  Dietetics,  Pharmacy,  and  Surgery,            .  .81 

The  Business  of  Teaching  not  confined  to  the  Museum,  .             89 

Devices  of  the  Priests  of  Serapis,        .             .             .  .89 

The  Teaching  of  Medicine  at  Alexandria,  after  the  period  of 

Herophilus  and  Erasistratus,              .             .  .             91 

The  Rationalists,  the  Empirics,  and  other  sects,           .  .91 


CHAPTER    VII. 

The  Schools  of  Smyrna,  Pergamus,  and  Epidaurus.  93 

CHAPTER    VIII. 

THE    SCHOOLS    OF    ROME. 

Section  I. — From  their  Origin  to  the  Else  of  the  Eclectics. 

The  Introduction  of  Grecian  Learning  among  the  Romans,  96 

Cato  the  Censor,        .             .             .             .             .  .96 

Caius  Marius,       .             .             .             .             .             .  97 

Asclepiades  of  Bithynia,         .             .             ,             .  .99 

Antonius  Musa,    .             .             .             .             .             .  102 

Cassius,  .......     102 

The  Early  Surgeons  and  Oculists  of  Rome,            ,             .  105 

The  Doctrines  of  the  Rationalists  and  Dogmatists,     .  .     106 

The  Doctrines  of  the  Empirics,     ....  108 


X  CONTENTS. 

PAGE 

Themison  of  Laodicea,  and  the  Doctrines  of  the  Methodic 

Sect,      .            .            .            .            .  .            .110 

Celsus,  and  his  Writings,               .             .  .             .           112 

Apiileius,       .......     121 

Scribonius  Largus,            .             .             .  .             .122 

Athenaeus,  and  the  Pneumatic  Sect,  .             .  .             .124 

Agathinus  and  the  Eclectics,        .             .  .             .           125 

Section  II. — The  Later  Methodists  of  the  Roman  School. 


Roman  Authors,  writing  in 

Greek,     . 

.     125 

Andromachus  of  Crete,    . 

.             . 

126 

Thessalus  of  Tralles, 

.             . 

.     126 

Philomenus, 

. 

127 

Archigenes,  . 

. 

.     12T 

Heliodorus, 

. 

128 

Antyllus, 

. 

.     128 

Soranus  of  Ephesus, 

. 

129 

Caelius  Aurelianus,     . 

... 

.     130 

The  Practice  of  the  Later  Methodists, 

132 

The  Obstetric  Art,     . 

. 

.     134 

Aspasia  and  Moschion,     . 

. 

135 

The  Culinary  Art,  Apicius 

Coelius,    . 

.     136 

Section  III. — Pliny  the  Elder. 

Contagion  and  Infection,      .             .             .             .  .140 

The  Art  of  Distilling  Alcohol  from  Wine,             .  .           141 

Progress  of  Medicine  at  Rome  up  to  the  time  of  Galen,  .       141 


CHAPTER    IX 


GREEK   WRITERS    AND    TEACHERS,    NOT    OF    THE    ROMAN    SCHOOL,    BUT 
CONTEMPORARY   WITH    IT. 


Dioscorides  of  Anazarba, 
Ruflfus  of  Ephesus,   . 
Aretseus  of  Cappadocia,   . 


143 
144 
145 


CONTENTS. 


XI 

PAGK 

147 


Marcellus  of  Sida,    ..... 
Quintus,  Marinus,  Satyrius,  and  others,  of  tlie  School  of  Perga- 

mus,  ......  14*7 


CHAPTER    X 


GALEN. 


His  Personal  History  and  Character, 

His  Writings, 

His  Discoveries  and  Doctrines, 


149 
153 

162 


CHAPTER    XI. 

LATIN    MEDICAL   WRITERS    SUBSEQUENT  TO    GALEN. 

Reasons  for  the  Decay  of  the  Roman  School,  .             .           174 

Serenus  Sammonicus,             .             .             .  .             .175 

Theodore  Priscian,            .             .             .  .             .176 

Marcellus  Empiricus,              .             .             .  .             .177 

Vegetius  Renatus,            .            .            .  .            .178 


CHAPTER    XII. 

GREEK    MEDICAL   WRITERS    AND    MEDICAL    INSTITUTIONS     SUBSEQUENT 

TO    GALEN. 


Caesarius,       ...... 

.     179 

Rivalry  in  the  Schools  of  Athens, 

181 

Oribasius,      ...... 

.     182 

Hospitals  and  Medical  Institutions  of  Christianity, 

186 

The  Hospital  of  Csesarea,       . 

.     187 

Perabolani,           ..... 

188 

The  Nosocomi,          ..... 

.     189 

Nemesius,  Bishop  of  Emessa, 

189 

Jacob  Psychrestus,    ..... 

.     191 

The  Last  of  the  Ancient  Latins,  Macer  Floridus,  . 

191 

Aetius,          ...... 

.     193 

Xll  CONTENTS. 

PA6S 

Alexander  Trallianus,       .  .  .  .  .  197 

Procopius,  his  account  of  the  Plague  and  of  the  Medical  Men 

during  the  reign  of  Justinian,  Human  Dissections,  .     200 

Suppression  of  the  Schools  of  Philosophy  and  other  Institutions 

of  Paganism,  .....  202 

Theophilus,    .......     202 

Stephen  of  Athens,  John  of  Alexandria,  and  Palladius,      .  203 

Ahrun,  ...  .  .  .  .  .     203 

Paul  of  ^gina,    ......  204 

Summary  view  of  the  Progress  and  Decline  of  Medical  Science 

among  the  Ancients,      .  .  .  .  .206 


CHAPTER    XIII. 

LAWS    AND    CUSTOMS    OF    THE     ROMAN    EMPIRE   IN    RELATION    TO    THE 
PROFESSION. 

The   usages  of  the   Profession   in   Rome,   adopted  from  the 

Greeks,         ......  208 

The  Term  of  Study,  .  .  .  .  .209 

System  of  Instruction,      .  .  .  .  .  210 

Servile  Practitioners,  .  .  .  .  .212 

The  Quacks  of  Rome,      .  .  .  .  .  214 

Schools  of  the  Provincial  Cities,  ....     214 

Their  Professors,  salaried  by  the  State,     .  .  .  215 

The  Edict  of  A.  D.  370,  in  reference  to  the  supervision  of  Stu- 
dents at  Rome,  .....  216 

Archiatri  Populares,  or  State  Physicians,  their  duties,  privi- 
leges, and  immunities,    .  .  .  .  .217 

The  care  of  Education  entrusted  to  them  ;  their  modes  of  grant- 
ing licenses  to  practice,         .  .  .  .  118 

The  Archiatri  Palatini,  or  Physicians  to  the  Imperial  House- 
hold,     .  .  .  .  .  .  .220 

Army  Physicians,  Private  Practitioners,  .  .  .  220 

Christian  Usages  and  Institutions,      .  .  .  .221 

Laws  of  the  Empire  relating  to  the  Profession,  never  abro- 
gated,   .......     222 


INTRODUCTORY  REMARKS. 


To  THE  E"ew  York  Academy  of  Medicine. 

Gentlemen  : — The  task  which  you  have  imposed 
upon  me,  and  which  I  come  before  you  this  evening 
to  fulfill,  is  one  for  which  I  am  ill  prepared.  Habits 
of  retirement  long  indulged,  are  not  easily  laid  aside. 
The  occupations  of  the  sick-room  favor  a  close, 
sententious  manner,  rather  than  fluency  of  speech. 

It  may,  indeed,  be  said,  that  in  this  respect  I  am 
only  on  a  par  with  my  associates.  Few  of  us,  it  is 
true,  are  known  as  public  speakers.  Eloquence  gives 
spirit  to  the  pulpit,  gives  spirit  to  the  bar ;  but  the 
Genius  of  Medicine  sits  pensive  and  alone,  her  finger 
on  her  lips,  as  if  admonishing  her  votaries  by  the 
example  of  her  own  silence,  to  bury  deep  within  the 
recesses  of  their  bosoms  the  disclosures  of  the  sick. 
Ours  is  the  quiet  profession.  The  prudent  physician 
is  the  keeper  of  his  own  counsel ;  thinking  much, 
and  speaking  little. 

But,  Gentlemen,  though  not  given  to  elocution,  I 

have  not  felt  at  liberty  to  refuse  this  opportunity  of 

addressing  you.     I  cannot  plead  the  diffidence  of  a 

stranger.     I  am  not  here  among  you  for  the  first 

2 


10  DISCOUESE. 

time.  I  stand  in  the  midst  of  friends, — of  brethren, 
— of  those  who  for  many  years  have  been  my  com- 
panions in  daily  toil,  moved  by  the  same  impulses, 
agitated  by  the  same  fears,  excited  by  the  same 
hopes,  elated  by  the  same  successes  as  myself. 
With  the  associations  of  a  quarter  of  a  century  clus- 
tering thick  around  me,  on  this  our  common  hearth, 
I  feel  that  I  am  at  home,  and  can  speak,  as  well  as 
breathe,  without  restraint. 

To  the  initiated.  Medicine  is  something  more  than 
a  profession.  It  is  a  world  within  itself.  It  has  its 
history,  its  philosophy,  its  politics,  its  literature,  of 
which  the  world  at  large  knows  nothing.  It  has  its 
subsidiary  arts  and  occupations.  It  has  its  organiza- 
tions and  institutions,  its  ranks  and  grades  of  honor. 
It  has  its  polemics  and  dissensions,  not  always  ame- 
nable to  logic  or  to  the  learning  of  the  schools.  In 
ethics,  traditions,  and  superstitions,  it  is  older  than 
the  church.  In  use  before  the  civil  law,  it  recog- 
nizes no  arbitrary  enactments.  Nature  is  its  only 
court  of  equity.  And  who  of  us  shall  forget  its  ever- 
living  charities;  its  moving  scenes  of  joy  and  sad- 
ness ;  its  many  sunny  aspects  ;  its  benignant,  enno- 
bling, liberalizing  influences  ;  which  few  beyond  our 
own  circle  can  properly  appreciate,  and  none  so 
well  understand  as  ourselves ! 

No  wonder,  then,  that  the  members  of  our  profes- 
sion, drawn  together  by  these  hallowed  ties,  should 
be  disposed  to  band  together  as  a  brotherhood. 
Such  has  always  been  their  course.  The  Druids  of 
early  Gaul  and  Britain,  the  Asclepiadse  of  Greece, 
the  priests  of  ancient  Egypt,  the  lamas  of  Central 


DISCOURSE.  11 

Asia,  the  Vaidhyas  of  India,  the  fraternities  of  the 
middle  ages,  and  up  to  the  present  hour  the  count- 
less societies  and  colleges  of  our  own  and  other 
lands  devoted  to  the  healing  art,  are  in  proof  of  this. 
So  that  wherever  social  freedom  has  existed,  or  tyr- 
anny would  permit,  internal  organization  and  devel- 
opment has  been  the  rule  of  our  profession. 

With  these  facts  before  us,  our  origin  and  growth 
as  an  element  of  civilization,  is  a  subject  worthy  of 
some  attention.  I  propose  to  occupy  the  passing 
hour  in  contemplating  it,  so  fair  at  least  as  relates 
to  the  condition  of  medicine  in  ancient  times,  and 
among  those  people  from  whom  the  usages  of 
modern  society  have  been  derived. 

This  subject  is  one  which  has  often  furnished 
occupation  for  my  leisure  hours.  It  is  pleasant  as 
well  as  profitable  to  turn,  on  fit  occasions,  from  the 
bustle  of  active  life,  to  the  study  of  the  past, — to  the 
origin  of  our  art,  to  the  principles  and  necessities 
that  called  it  into  being,  to  the  struggles  of  our  an- 
cestry. We  are  thereby  better  able  to  understand 
our  own  position,  to  know  how  far  we  have  ad- 
vanced, to  whom  we  owe  our  progress,  the  labor  still 
before  us,  and  the  places  we  ourselves  are  likely  to 
occupy  in  the  estimation  of  those  who  are  to  follow 
us. 


12  DISCOURSE 


CHAPTER     I. 

THE  CONDITION    OF   MEDICINE    IN   THE   EARLIEST    OR- 
GANIZATIONS   OF    SOCIETY. 

The  art  of  medicine  is  at  the  present  day  so  ifni- 
versally  exercised,  that  we  can  hardly  suppose  an 
organized  community  ever  existed  in  which  it  was 
overlooked  ;  and  yet  such  appears  to  have  been  the 
fact. 

There  is  reason  to  believe  that  among  the  Assy- 
rians and  other  early  Asiatics,  it  was  never  pursued 
as  a  distinct  occupation.  The  eastern  Magi  must 
have  devoted  some  attention  to  it ;  and  the  seers  of 
Palestine  may  have  had  some  pretensions  to  skill  in 
the  cure  of  diseases  as  a  part  of  their  divine  calling. 
Job  speaks  of  his  counselors  as  "  physicians  of  no 
value ;"  and  Moses,  of  the  preparation  of  the  sacred 
oil  after  "  the  apothecary's  art."  King  Asa,  when 
his  disease  was  exceeding  great  "  sought  not  the 
Lord,  but  his  physicians ;"  and  Jeremiah  asks,  "  Is 
there  no  balm  in  Gilead  ?  is  there  no  physician 
there  ?"  From  these  and  other  allusions  in  the  Old 
Testament,  it  is  evident  that  among  the  Israelites 
there  were,  perhaps  after  the  manner  of  the  Egypt- 
ians, certain  men  giving  their  attention  to  medicine. 
But  the  Babylonians,  as  we  learn  from  Herodotus,* 

*  Book  I.  chap.  197. 


DISC  O'U  E  S  E  .  13 

were  destitute  of  physicians,  and  in  the  custom  of 
exposing  their  sick  in  the  market-place,  in  order  that 
those  who  had  been  similarly  affected  might  com- 
municate to  them  the  means  of  cure.  The  kings  of 
Persia  had  no  physicians  of  their  own  nation  ;  but 
were  in  the  habit  of  obtaining  them  from  Egypt,  or 
luring  them  by  rich  rewards  from  Greece.  The 
early  Komans  were  in  like  condition.  Their  first 
attempt  to  secure  competent  medical  attendance, 
was  in  the  year  of  the  city,  535  ;  when  they  induced 
Archagathus  of  Peloponnesus  to  settle  amongst  them, 
offering  him  the  freedom  of  the  city,  furnishing  him 
with  a  residence,  and  providing  liberally  for  his  sup- 
port at  the  public  expense.  But,  as  we  learn  from 
Pliny,*  Archagathus  proved  to  be  their  ''  carnifex  " 
rather  than  their  "  vulnerarius ;"  so  that  their  first 
effort  not  turning  to  their  advantage,  they  were  not 
soon  again  disposed  to  repeat  it ;  and  we  find  Cato, 
nearly  a  century  afterwards,  relying  for  medical 
assistance  upon  charms  and  superstitious  observ- 
ances of  his  own,  or  upon  the  untutored  skill  of  his 
domestics.f 

In  the  earliest  stages  of  civilization,  among  most 
primitive  people,  where  medicine  is  practiced  at  all, 
the  functions  of  the  physician  are  usually  united 
with  those  of  the  priest  and  civil  ruler. 

The  oak-groves  of  ancient  Europe  were  as  sacred 
to  medical  observances  as  to  the  other  mysteries  of 
Druidism.  The  blossoming  of  the  mistletoe  and  the 
ripening  of  its  berries,  at  the  summer  and  the  win- 

*  Nat.  Hist,  lib.  xxix.,  cap.  vi.  viii-       f  Cato  de  Re  Rustica,  cap.  160. 


14  DISCOUKSE. 

ter  solstice,  marked  the  seasons  of  the  sacred  feasts  ; 
and  after  adorning  the  ceremony  of  the  sacrifice, 
the.  hallowed  plant  was  carefully  set  aside  by  the 
ovate  and  physician  of  the  tribe,  to  be  used  in  case 
of  need  as  a  medicine."^ 

According  to  Hindoo  mythology  there  are,  be- 
sides Brahma,  the  creator,  not  less  than  six  minor 
divinities  skilled  in  the  healing  art.  The  ancient 
and  still  existing  caste  of  Hindoo  physicians,  the 
Vaidhyds,  trace  their  family  descent  from  Virab- 
hadra,  the  fortunate,  the  son  of  Brahma.  It  was  to 
the  thirteen  sons  of  this  demi-god  that  were  first  re- 
vealed the  sacred  sagas,  by  the  study  of  which  they 
and  their  descendants  to  the  present  day,  have  been 
rendered  learned  pundits  and  skillful  physicians.f     ' 

Among  the  Tartars,  the  lama  is  the  only  physi- 
cian. One  of  these  people,  conversing  with  a  recent 
traveler  J  on  the  subject  of  the  war  between  China 
and  England,  says,  "  The  Chinese  were  everywhere 
protesting  that  we  were  marching  to  certain  death. 
*  What  can  you  do,'  say  they,  '  against  these  sea- 
monsters  !  They  live  in  the  water  like  fish.  When 
least  expected  they  appear  on  the  surface,  and  throw 
combustible  balls  of  iron.  When  the  bow  is  bent 
against  them  they  take  to  the  water  like  frogs.' 
Thus  they  tried  to  frighten  us.  But  we  soldiers  of 
the  Eight  Banners  are  ignorant  of  fear.     The  em- 


*  Giles,  in  Richard  of  Cirencester's  Ancient  Britain. 

f  Wise,  Hindoo  System  of  Medicine.  Calcutta,  8vo.,  1845.  Chap,  ii., 
p.  11. 

X  M.  Hue.  "  Souvenirs  d'un  Voyage  dans  la  Tartaric,  la  Thibet,  et  la 
Chine."    See  Edinburgh  Reviaw,  April,  1851,  p.  201. 


DISCOURSE.  15 

peror  has  supplied  eacli  leader  with  a  lama  instruct- 
ed in  medicine,  and  initiated  in  all  sacred  auguries, 
able  to  protect  us  from  the  diseases  of  the  climate, 
and  to  save  us  from  the  magic  of  the  sea-monsters. 
"What,  then,  have  we  to  fear  ?  The  rebels  hearing 
that  the  invincible  troops  of  Tchakar  were  approach- 
ing, *  *  *  sued  for  peace ;  *  *  *  and  then  we  re- 
turned to  our  pastures,  and  to  the  charge  of  our 
flocks." 

Again,  among  the  aborigines  of  our  own  country, 
the  functions  of  the  physician  are  in  the  hands  of 
the  priest.  The  Tla-quill-augh,  or  man  of  supernatu- 
ral gifts,  is  supposed  to  know  all  things,  and  to  be 
capable  of  throwing  his  good  or  bad  medicine,  with- 
out regard  to  distance,  on  whom  he  will ;  and  to  kill 
or  cure  by  magic  at  his  pleasure.  These  Tla-quill- 
aughs  are  generally  men  beyond  the  meridian  of 
life ;  grave,  sedate,  and  shy,  with  a  certain  air  of  cun- 
ning ;  but  possessing  some  skill  in  the  use  of  herbs 
and  roots,  and  in  the  management  of  injuries  and 
external  diseases.  The  people  at  large  stand  in  great 
awe  of  them,  and  consult  them  on  every  affair  of  im- 
portance. But  their  personal  safety  is  not  in  pro- 
portion to  their  influence.  Every  misfortune,  unseen 
evil,  or  sudden  death  among  the  people,  is  immedi- 
ately attributed  to  them.  And,  however  innocent 
of  the  calamity,  they  are  apt  to  pay  for  it  with  their 
lives.* 

These  customs  of  the  savage,  springing  as  they  do 
out  of  the  untutored  instincts  of  the  human  heart, 


*  Ross.    "Adventures  on  the  Oi-egon  and  Columbia  River.' 


16  DISCOURSE. 

may  be  taken  as  no  inapt  illustration  of  what  may 
liave  been  the  first  estate  of  medicine  among  those 
people  from  whom  it  has  descended  to  ourselves. 
Overlooking  the  juggleries  of  the  Indian  priests,  the 
philosopher  will  discover  that  their  real  force  lies 
precisely  in  that  department  of  the  art  which,  in  an- 
cient times,  was  cultivated  earliest,  and  with  most 
success  ;  and  that  the  foundation  for  the  future  de- 
velopment of  medical  science  among  them,  is  quite 
as  broad  as  that  upon  which  the  enduring,  but  still 
unfinished  temple  of  medicine  was  originally  begun, 
more  than  thirty  centuries  ago  ;  the  first  architects 
of  which,  like  the  Tla-quill-aughs  of  Oregon,  were 
also  of  the  order  of  the  priesthood. 


Among  the  early  Egyptians  the  priests  were  a 
numerous  and  influential  body ;  receiving  for  their 
support  about  one-third  of  the  whole  income  of  the 
nation.  They  were  of  several  orders  ;  most  of  them 
skilled  in  medicine,  and  practicing,  as  some  suppose, 
gratuitously  among  the  people.*  "  Here,"  says  He- 
rodotusf,  ''each  j)hysician  apj^lies  himself  to  one 
disease  only,  and  not  more, — all  places  abound  in 
physicians  ;  some  for  the  eyes,  others  for  the  head, 
others  for  the  teeth,  others  for  the  parts  about  the 
belly,  and  others  for  internal  diseases."  Of  this 
same  class  were  the  embalmers,;};  whose  occupation 
must  have  rendered  them  familiar  with  the  internal 


Schulze,  p.  24,  from  Diodorus  Siculus.  f  Book  II.  c.  84. 

X  Herodotus,  Book  II.  ch.  86,  et  seg. 


DISCOURSE.  IT 

structure  of  tlie  body,  and  furnislied  tliem  witli  use- 
ful insiglit  into  the  nature,  causes,  and  results  of  dis- 
eased action.  The  deference  paid  to  the  medical 
skill  of  the  Egyptian  priests,  was  not  confined  to 
their  own  people.  They  were  sought  for  by  the 
rulers  of  the  surrounding  nations,  and  sometimes 
sent  abroad  against  their  will.  Cambyses,  the  Per- 
sian, demanded  the  daughter  of  Amasis,  king  of 
Egypt,  at  the  instigation  of  a  physician,  who  had 
been  forced  by  Amasis  from  his  native  country,  and 
had  taken  this  mode  of  revenge  for  having  been 
torn  from  his  wife  and  children  to  gratify  the  re- 
quest of  Cyrus,  who  had  asked  for  the  ablest  oculist 
of  Egypt."^  The  attendants  on  Cambyses  must  have 
known  something  of  the  internal  structure  of  the 
human  frame  ;  for,  having  shot  an  arrow  through 
the  body  of  a  child,  the  son  of  Prexaspes,  to  prove 
his  skill  in  archery,  he  ordered  them  to  open  him 
and  examine  the  wound ;  when  the  arrow  was  found 
to  have  pierced  the  heart.f  The  practice  of  the 
Egyptian  priests,  as  we  learn  from  Aristotle, J  was 
in  conformity  with  a  prescribed  law.  "  Even  in 
Egypt,"  says  he,  "  the  physician  was  allowed  to  alter 
the  mode  of  cure  which  the  law  prescribed  to  him, 
after  the  fourth  day.  But  if  he  did  so  sooner,  he 
-  acted  at  his  own  peril." 

*  Herodotus.    Book  III.  c.  1.  f  Ibid.^    Book  III.  c.  35. 

X  Politics.    Book  III.  c.  15. 


18  DISC0TJR8E 


CHAPTER     II 


THE    OEIGIN   OF   MEDICESTE   AMONG   THE   GEEEKS. 

Amon-g  the  Greeks  fhe  art  of  medicine  appears  to 
Tiave  been  derived  from  three  sources;  the  Gym- 
nasia, the  schools  of  Philosophy,  and  the  Temples 
of^^sculapius.*^ 

X.  At  the  Gymnasia  the  course  of  education  con- 
sisted, first,  of  music,  which,  according  to  the  ancient 
use  of  the  term,  included  every  study  for  develop- 
ing the  intellectual  and  moral  faculties ;  and  sec- 
ondly, of  gymnastics,  in  which  was  included  every 
exercise  for  strengthening  and  improving  the  body. 
It  was  a  rule  with  these  people  that  what  the  boy 
first  learns  in  sport  he  will  afterwards  love,  and  ex- 
ercise with  more  ability  as  the  serious  occupation  of 
his  manhood ;  and  hence,  that  children  should  prac- 
tice as  amusements  such  sports  as  are  best  suited  to 
prepare  them  for  their  future  occupations.f  The 
course  of  intellectual  training  at  the  gymnasia,  ac- 
cording to  Plato,J  began  with  the  sixth  and  ended 
with  the  twentieth;  or,  according  to  Aristotle,§ 
began  with  the  seventh  and  ended  with  the  twenty- 

*  Littr^,  (Euvres  d'Hippocrate,  Introduction,  tome  i.  p.  5. 
f  Plato,  Laws.    Bk.  i.  ch.  12. 
\  Laws.     Bk.  vii.  c.  4. 
§  Politics.    Bk.  vii.  c.  1*7. 


DISCOUESE.  19 

first  year.  For  learning  to  read  and  write,  accord- 
ing to  Plato,*  three  years  will  suffice  for  a  boy  com- 
mencing at  ten  years  old  ;  and  the  three  succeeding 
years  will  be  sufficient  for  the  handling  of  the  lyre. 
The  free-born  are  also  to  be  educated  in  computa- 
tion, in  geometry  and  astronomy ;  not  all,  indeed, 
with  equal  nicety.  But  such  as  may  be  necessary 
for  the  masses,  it  would  be,  says  he,  shameful  for 
the  many  to  neglect.  That,  however,  which  tends 
merely  to  the  acquisition  of  wealth  or  bodily 
strength,  or  any  other  cleverness  apart  from  intel- 
lect and  justice,  he  excludes  from  this  course  of 
training,  as  not  worthy  to  be  called  education  at 
all ;  applying  this  term  only  to  that  which  tends  to 
virtue, — which  causes  one  to  feel  a  desire  of,  and  love 
for  becoming  a  perfect  citizen,  and  to  know  how  to 
govern,  and  be  governed.  ^ 

In  connection  with  this  intellectual  course,  the 
physical  exercises  were  also  systematically  pursued 
at  the  gymnasia.  These  latter  embraced  not  merely 
wrestling,  racing,  and  other  athletic  sports ;  but 
also  the  general  rules  of  health;  attention  to  the 
food  most  proper  for  invigorating  the  frame,  for 
increasing  the  powers  of  endurance  against  fasting, 
fatigue,  watching,  exposure  to  the  weather  or  to  the 
vicissitudes  of  the  seasons ;  and  to  every  circum- 
stance likely  to  prepare  the  youth  for  serving  as 
soldiers  in  defense  of  their  country,  or  for  acquiring 
applause  in  contests  with  one  another  at  the  Olym- 
pic, Pythian,  or  other  national  festivals.    These  exer- 

*  Laws.    Bk.  vii.  c.  14, 


20  DISCOUESE. 

cises,  however,  were  not  confined  to  youtli.  The 
people  of  every  rank  engaged  in  them.  At  the 
Palestrae,  in  which  they  were  conducted,  injuries 
were  of  frequent  occurrence.  The  Gymnasiarchs  in 
charge  of  these  institutions,  as  well  as  the  latrolep- 
tists,  or  anointers,  who  assisted  them,  had  constant 
opportunity  of  witnessing  and  treating  accidents ; 
and  from  the  experience  thus  acquired,  these  men 
were  in  some  degree  trained  to  the  management  of 
diseases  originating  from  other  causes.  The  Ho- 
meric heroes  had  probably  acquired  their  surgical 
skill  in  this  manner.  But  if  some  of  them,  as 
Machaon  and  Padalirius,  possessed  extraordinary 
ability  in  the  treatment  of  injuries,  they  were  not 
exclusively  devoted  to  its  exercise ;  for  they  were 
quite  as  ready  at  inflicting  wounds  as  at  curing 
them. 

I  2.  At  the  schools  of  philosophy  some  attention 
was  always  devoted  to  medicine- as  a  department  of 
speculative  knowledge.  The  School  of  Pythagoras, 
at  Crotona  in  Magna  Greecia,  now  the  south  of 
Italy,  preceded  that  of  Plato  by  more  than  a  cen- 
tury. Before  assuming  the  business  of  teaching, 
Pythagoras  had  spent  much  time  in  Egypt ;  and  he 
probably  introduced  something  of  Egyptian  science 
in  his  course  of  instruction  at  Crotona,  where  medi- 
cine was  first  cultivated  as  a  department  of  philoso- 
phy. Of  this  school  were  Empedocles,  the  author 
of  a  medical  poem ;  Alcmseon,  who  was  occupied  in 
the  dissection  of  brute  animals ;  and  Democedes, 
the  most  skillful  physician  of  his  time,  who  flour- 
ished more  than  a  century  before  Hippocrates.     Of 


DI800TJBSE.  21 

this  same  scTiool  also  was  Acron,  tlie  first  of  bis  sect 
to  give  attention  to  practical  rather  than  to  specu- 
lative inquiries  ;  and  who  is  said  to  have  arrested 
the  progress  of  an  epidemic  at  Athens,  by  kindling 
large  fires  in  different  parts  of  the  city.  To  him  the 
Empirics,  a  sect  of  much  later  date,  were  ambitious 
of  tracing  their  opinions.  He  was  the  author  of  a 
treatise  on  nutrition,  which  had  perished  before  the 
age  of  Pericles. 

Of  these  philosophers,  Democedes  is  the  only  one 
who  is  known  to  have  devoted  himself  to  medicine 
as  an  industrial  occupation.  Leaving  Crotona  and 
his  father's  house,  he  first  settled  at  JEgina ;  where, 
though  poorly  provided  with  the  instruments  of  his  art, 
he  soon  surpassed  the  most  expert  of  the  physicians. 
In  the  second  year  the  ^ginetae  engaged  him,  for  a 
talent  out  of  the  public  treasury ;  in  the  third  year, 
the  Athenians,  for  a  hundred  minge ;  and  in  the  fourth 
year,  Polycrates,  for  two  talents.  He  subsequently 
accompanied  this  prince  in  a  maritime  expedition 
from  Samos  to  Asia  Minor ;  where  he  fell  into  the 
hands  of  the  Persians.  He  afterwards  rose  to  dis- 
tinction by  curing  Darius  of  an  injury  of  the  ankle, 
which  the  Egyptian  physicians  had  failed  to  relieve ; 
and  thus  he  acquired  great  influence  at  Susa,  sitting 
at  the  king's  table,  overwhelmed  with  riches,  and  in 
the  enjoyment  of  every  honor  and  privilege  which 
Darius  could  bestow,  excepting  only  the  privilege 
of  returning  to  his  native  country — a  privilege  for 
which  he  languished ;  and  which,  after  curing 
Atossa,  the  wife  of  Darius  and  daughter  of  Cyrus, 
of  a  tumor  of  the  breast,  he  finally  obtained  by 


22  DISCOURSE. 

stratagem.  In  the  time  of  Democedes,  the  phys- 
icians of  Crotona,  according  to  Herodotus,  were 
esteemed  to  be  the  ablest  in  Greece,  and  the  Cyren- 
86ans  the  second  * 

The  writings  of  Plato  and  Aristotle  are  filled  with 
allusions  to  our  art ;  and  from  it  they  are  continually 
drawing  their  happiest  illustrations.  Plato  had  the 
following  inscription  over  the  door  of  his  Academy  : 

"  Let  none  ignorant  of  geometry  enter  here."-}- 

And  whether  this  is  to  be  understood  literally,  or  as 
referring  to  previous  moral  and  intellectual  training, 
it  is  evident  he  sought  to  give  instruction  only  to 
such  as  had  already  received  elementary  education 
sufficient  to  enable  them  to  appreciate  and  profit  by 
his  discourses.  Nor  could  his  pupils  have  been  more 
than  voluntary  listeners.  For  when  reading  to  them 
his  dialogue  "  On  the  Soul,"  the  most  of  them  rose 
and  departed,  Aristotle  alone  remaining  to  be  edi- 
fied by  its  reasonings.^  This  school  was  of  small 
beginning.  The  little  orchard  adjoining  the  Acad- 
emy, constituted  Plato's  principal  patrimony.  Be- 
fore he  began  to  teach,  it  yielded  him  only  two 
aurei  nummi  annually.  But  the  revenue  derived 
from  it  in  course  of  time,  amounted  to  more  than  a 
thousand ;  for  it  was  much  enlarged  by  well-wishers 
and  studious  persons,  who  bequeathed  something  of 
their  wealth  to  the  philosophers.  Plato  exacted  no 
pecuniary  recompense  from  his  pupils.     But  Aris- 

*  Herodotus.    Bk.  iii.,  ch.  129,  et  seq. 

f  Stanley.     History  of  Philosophy.     Fol.  Lond.,  168T,  p.  262. 
X  Diogenes  Laertius,  in  Life  of  Plato.     Chap.  37. 


DISCOURSE.  23 

tippus,  who  had  been  his  fellow-pupil  under  Socra- 
tes, and  was  afterwards  the  founder  of  the  Cyreniac 
sect,  believing  that  instruction  is  the  more  highly- 
valued  by  the  money  paid  for  it,  gave  the  first 
example  among  the  philosophers  of  charging  for  his 
lectures ;  an  example  afterwards  followed  at  the 
Academy,  where  Speusippus,  the  nephew  and  succes- 
sor of  Plato,  established  thS"  fee  for  a  course  of  dia- 
lectics at  a  mina.  Polemo,  the  third  in  succession, 
after  Plato,  lived  within  the  garden  of  the  Academy ; 
whilst  his  disciples,  to  be  near  the  school,  built  for 
themselves  little  lodges  round  about  it.  Cratnor,  a 
disciple  of  Polemo,  being  in  ill  health,  took  up  his 
abode  at  the  temple  of  -^sculapius  in  Athens, 
where  it  was  his  intention  to  establish  an  inde- 
pendent school  of  his  own ;  but  regaining  his  health, 
he  relinquished  this  purpose,  and  afterwards  be- 
queathed his  possessions  to  the  Academy.  Attains, 
king  of  Pergamus,  subsequently  enlarged  and  orna- 
mented its  public  grounds;  which  were  thencefor- 
ward called  the  "  Gardens  of  Attains."  Xenocrates, 
the  successor  of  Speusippus,  in  consequence  of  the 
great  number  of  youth  resorting  to  him,  was  obliged, 
for  the  proper  government  of  the  Academy,  to 
establish  a  regular  system  of  police,  and  to  appoint 
officers  from  time  to  time  for-  carrying  his  regula- 
tions into  effect. 

The  government  of  the  Lyceum  was  nearly  the 
same  as  that  of  the  Academy.  From  the  life  of 
Theophrastus,  the  successor  of  Aristotle,  we  learn, 
that  voluntary  contributions  were  occasionally  taken 
up  for  the  maintenance  of  the  philosophers ;  that  for 


24  DISCOURSE. 

the  order  and  economy  of  the  institution,  the  regu- 
lation of  its  tenements,  altars,  statues,  and  ornamen- 
tal grounds,  there  were  special  officers  appointed, 
and  laws  established,  by  the  governor;  and  that, 
besides  those  who  were  associated  together  as  phil- 
osophers, there  were  immense  numbers  of  young 
men  resorting  to  the  institution ;  some  of  whom  ap- 
pear to  have  been  occasionally  admitted  to  the 
tables  of  their  instructors. 

Both  of  these  institutions  were  in  some  degree 
under  the  cognizance  of  the  republic.  The  people 
occasionally  exercised  the  right  of  closing  them,  and 
of  silencing  or  restraining  the  teachers,  according  as 
their  doctrines  countenanced  or  opposed  the  preju- 
dices, policy,  or  religious  tendencies  of  the  com- 
munity. 

Those  who  had  gone  through  the  course  as  or- 
dinary students,  occasionally  chose  afterwards  to 
remain  as  permanent  residents.  Aristotle,  before 
opening  his  own  school  at  the  Lyceum,  had  been  a 
member  of  the  Academy  for  more  than  twenty 
years.  From  among  the  permanent  residents,  the 
director  usually  selected  his  successor.  Thus,  Strato, 
the  second  after  Aristotle  at  the  Lyceum,  ordered 
in  his  will,  that  Lyco  should  succeed  him ;  giving  as 
a  reason,  that  the  others  were  either  too  old,  or 
otherwise  employed;  and  requesting  them  to  con- 
firm his  choice. 

How  much  of  medicine  may  have  entered  into 
the  systematic  course  of  instruction  at  either  of  these 
institutions,  we  have  not  now  the  means  of  ascer- 
taining.    That   Plato  was  well  versed  in  the  prin- 


DISCOURSE.  25 

ciples  of  tlie  art,  as  taught  by  his  contemporary,  Hip- 
pocrates, his  works  bear  abundant  evidence.  Accord- 
ing to  his  biographer,  Diogenes  Laertius,*  he  divided 
medicine  into  five  branches:  the  pharmaceutic,  the 
chirurgic,  the  dietetic,  the  nosognomic,  and  thebceth- 
etic  :  the  first  cures  by  means  of  drugs,  the  second 
by  cutting  and  burning,  the  third  produces  a  change 
in  the  diseased  by  a  change  in  their  diet,  the  fourth 
makes  known  the  character  of  disease,  and  the  fifth 
by  instant  assistance  palliates  suffering,  and  gives 
relief  to  pain.  Aristotle,  though  no*t  a  practitioner 
of  medicine,  was  of  the  family  of  the  Asclej^iadse. 
He  was  well  skilled  in  natural  history  and  the 
anatomy  of  the  lower  animals,  as  well  as  in  the  medi- 
cal doctrines  of  his  own  and  former  times.  We  shall 
again  have  occasion  to  allude  to  him  as  a  naturalist. 
3.  But  notwithstanding  the  speculations  of  the 
philosophers,  and  the  trainings  of  the  Palestrae,  the 
Temples  of  JEsculapius  were  the  first  great  founda- 
tions of  medical  knowledge  among  the  Greeks. 

These  Temples  were  numerously  dispersed 
throughout  the  Grecian  states  and  colonies,f  as  at 
Titane,  Epidaurus,  Gyrene,  Rhodes,  Orope  in  Attica, 
Cylene  in  Ellis,  Tithorea  in  Phocion,  Tricca  in  Thes- 
saly,  Megalapolis  in  Arcadia,  Cnidos,  Cos,  Corona, 


»  Chapter  85.     In  Plato,  Bohn's  edition,  vol.  6,  p.  21'7. 

f  Schulze,  in  his  Historia  Medieinse,  p.  118  and  p.  127,  quarto,  Lipsise, 
1*728,  enumerates  and  describes  the  particulars  of  more  than  eighty  of  them, 
mostly  after  Pausanias  and  Plutarch ;  and  several  of  the  states  and  cities 
appear  to  have  been  provided  with  more  than  one  for  each  place.  The 
temple  at  Epidaurus,  the  reputed  birthplace  of  Ji^sculapius,  is  presumed  to 
be  among  the  most  ancient  of  them;  and  from  this,  many  of  the  others  are 
known  to  have  been  off-shoots. 

3 


26  DISCOURSE. 

Pergamus,  Corintli,  Smyrna,  and  numerous  other 
places.  Here  were  originally  tlie  homes  of  the 
A33lepiad8e,  the  schools  in  which  they  trained  their 
offspring;  and  hither  the  suffering  and  afflicted 
resorted  for  consolation  and  relief. 

The  priests  of  ^sculapius  were  in  the  habit  of 
turning  to  good  account  the  opportunities  at  their 
command  within  the  temples.  The  institution  of 
the  votive  tablets  on. which  were  inscribed  the  his- 
tory of  the  cases  which  had  been  relieved  by  them, 
indicates  plainly  that  the  idea  of  collecting  the 
information  thus  recorded,  and  deducing  therefrom  a 
systematic  code  of  practice,  must  have  been  contem- 
plated by  the  descendants  of  ^sculapius  at  an  early 
day. 

These  temples,  or  Asclepions,  long  before  medicine 
began  to  assume  a  scientific  character,  had  served  as 
schools  of  instruction,  and  as  asylums  for  the  sick. 
They  furnished  the  nucleus  from  which,  in  process 
of  time,  were  developed  other  institutions  and 
organizations.  As  schools,  the  most  ancient  of  them 
is  said  to  have  been  at  Titane,  near  Sicyon.  Those 
of  Rhodes  and  Epidaurus,  were  of  early  repute. 
But  the  school  of  Cnidos  is  that  from  which  issued 
the  earliest  literary  performance  which  can  be 
clearly  traced  to  the  Asclepiadse,  namely,  the  "  Cni- 
dian  Sentences  ;"  which  are  attributed  to  Euryphon, 
the  contemporary  of  Hippocrates,  though  somewhat 
his  senior.*  As  asylums,  the  temples  bore  no  inapt 
resemblance  to  the  hospitals  and  infirmaries  of 
modern   times;  into  which,  in  fact,  some  of  them 

*  Littre,  loco  citat.  p.  Y. 


BISCOUESE.  27 

were  ultimately  converted.  The  temples  of  Epi- 
daurus,  Cos,  Tricca,  according  to  Strabo,  were 
always  filled  witli  patients ;  and  along  their  walls 
the  tablets  were  suspended  upon  which  were 
recorded  the  history  and  treatment  of  the  individual 
cases  of  disease.* 

The  choice  of  situation,  and  internal  management 
of  the  temples,  show  with  what  care  the  priest  of 
JEsculapius,  Avhile  observing  the  rites  of  his  reli- 
gion, provided  for  the  well-being  of  the  sick.  They 
usually  occupied  some  elevated  or  retired  and 
healthy  locality,  not  far  removed  from  the  cities, 
surrounded  by  shady  groves,  or  in  the  neighbor- 
hood of  thermal  springs,  or  fountains  of  medicated 
water.  They  were  sacred  from  intrusion,  and  acces- 
sible to  the  sick  only  after  suitable  preparation. 
The  invalid,  on  his  arrival,  submitted  to  purification, 
by  fasting,  ablution,  and  inunction.  He  afterwards 
passed  the  night  within  the  Hicetas  or  common-hall 
of  the  temple.  During  this  ceremony  of  incubation, 
the  presiding  deity  is  supposed  to  appear  before  him 
in  the  silence  of  the  night,  and,  by  voice  or  other- 
wise, announce  to  him  the  means  of  cure  ;  which,  on 
the  following  day,  the  priest  in  attendance  also 
ascertained,  and  afterwards  undertook  the  super- 
vision of  the  treatment. 

The  fees  of  these  priests  were  the  free-will  ofier- 
ings  of  the  sick.  It  was  consequently  to  the  inter- 
est of  the  priests  to  cherish  the  superstitions  of  the 
people.     Their  devices  for  this  purpose,  Aristoph- 

*  Ibid,  p.  9,  from  Strabo,  boak  viii. 


28  DISCOURSE. 

anes  has  humorously  portrayed  in  his  comedy  of 
Plutus. 

"  Having   bathed   Plutus   in   the  sea,"  says   the 
servant  Cario,  "we  went  to  the  temple  of  JEscu- 
lapius;  and  when  our  wafers  and  preparatory  sacri- 
fices were  offered  on  the  altar,  and  our  cakes  on  the 
flame  of  Vulcan,  we  laid  him  on  a  couch,  as  was 
proper,  and  made  ready  our  own  mattresses.    *  *  * 
When  the  priest  had  extinguished  the  lights,  he 
told  us  to  go  to  sleep,  adding  that  if  any  of  us 
heard  the  hissing  we  should  by  no  means  stir.     We 
therefore  all  remained  in  bed,  and  made  no  noise. 
As  for  myself,  I  could  not  sleep,  on  account  of  the 
odor  of  a  basin  of  savory  porridge  which  an  old 
woman  had  at  the  side  of  her  bed,  and  which  I 
longed  for  amazingly.     Being,  therefore,  anxious  to 
creep  near  it,  I  raised  my  head,  and  saw  the  sacris- 
tan take  the  cakes  and  dried  figs  from  the  sacred 
table,  and  going  the  round  of  the  altars,  put  all  that 
he  could  find  into  a  bao^.     It  occurred  to  me  that  it 
would  be  meritorious  in  me  to  follow  his  example, 
so  I  arose  to  secure  the  basin  of  porridge,  ^  *  fear- 
ing only  that  the  priest  might  get  at  it  before  me, 
with  his  garlands  on.  ^  *  The  old  woman,  on  hear- 
ing me,  stretched  forth  her  hand.     But  I  hissed,  and 
seized  her  fingers  with  my  teeth,  as  if  I  were  an 
^sculapian  snake;  then,  drawing  back  her  hand 
again,  she  lay  down  and  wrapped  herself  up  quickly, 
*  *  ^  while  I  swallowed  the  porridge,  and,  when 
full,  retired  to  rest." 

The  serpent  to  which  Aristophanes  here  refers, 
was  the  usual  emblem  of  the  presiding  Numen,  or 


DISCOUESE.  29 

divinity  of  the  temple ;  thougli  other  animals,  as 
the  cock  and  the  dog,  were  occasionally  employed 
for  the  same  purpose.  The  figure  of  the  serpent 
sculptured  in  stone,  met  the  eye  of  the  devotee  at 
the  entrance  of  the  temple ;  and  the  animal  itself 
was  cherished  and  preserved  within  the  sacred  pre- 
cincts. The  ^sculapian  serpent,  according  to  Pau- 
sanias,  was  of  a  peculiar  variety,  of  a  yellowish  or 
brown  color,  and  found  only  at  Epidaurus.  At  the 
founding  of  new  temples,  it  was  always  transferred 
from  the  old  to  the  new  abodes.  Such  was  the  cere- 
mony, as  we  learn  from  Livy,  when  in  the  year  of 
Eome,  461,  for  arresting  the  progress  of  pestilence 
dn  that  city,  commissioners  were  sent  to  transfer  the 
sacred  serpent  from  Epidaurus  to  the  Island  of  the 
Tiber,  where  the  first  temple  to  JEsculapius  was 
erected  among  the  Romans. 

^sculapius  himself  was  usually  represented  as  a 
bearded  and  aged  man;  sometimes  bare-headed, 
sometimes  crowned ;  seated,  standing  erect,  or  lean- 
ing on  his  staff,  around  which  the  serpent  is  seen 
winding  in  spiral  folds ;  occasionally  he  is  bearing  a 
strobile  of  the  pine ;  sometimes  he  is  seen  alone,  but 
more  frequently  accompanied  by  one  of  his  daugh- 
ters, usually  Hygeia,  who  is  robed  in  white,  with  a 
serpent  in  one  of  her  hands  and  a  shallow  patella  or 
cup  in  the  other,  to  which  the  serpent  is  directing  its 
attention.  Not  unfrequently  between  the  figures  of 
jEsculapius  and  Hygeia,  a  child  is  seen  standing,  the 
infant  Telephorus  or  the  Harpocrates  of  the  Egyp- 
tians ;*  and  the  cock  is  usually  seen  at  the  feet  of 

*  Schulze,  p.  126,  131,  et  eeq. 


30  DISCOURSE. 

^^sculapius.  By  the  serpent,  tlie  Asclepiadse  are 
^supposed  to  have  symbolized  circumspection  and 
vigilance,  and  as  Schulze  supposes,  the  power  of 
rejuvenescence;  by  the  cock,  their  bird  of  sacrifice, 
they  are  thought  also  to  have  represented  vigilance ; 
and  by  the  dog,  fidelity  and  honesty.  The  Egyp- 
tian symbols  of  Serapis,  or  of  Isis  and  Osiris,  and 
the  infant  Harpocrates,  were  occasionally  associated 
with  the  emblems  more  properly  belonging  to  the 
Greeks — a  custom  adopted  after  the  settlement  of 
Alexandria.  For  it  was  a  belief  among  the  Egyp- 
tians, that  infants  had  at  times  the  power  of  divina- 
tion ;  and  in  the  sacred  ceremonies  of  their  temples, 
the  sports  and  gambols  of  young  children  were  often 
introduced.*  But  in  the  temples  of  Isis  and  Osiris 
the  genius  of  medicine  was  sometimes  also  repre- 
sented by  the  figure  of  Silence.  "Et  quoniam  vero 
in  omnibus  templis  ubi  colebantur  Isis  et  Serapis 
erat  etiam  simulacrum  quod,  digito  labiis  impresso, 
admovere  videretur  ut  silentium  fieret ;  hoc  signifi- 
cere,  ut  homines  illos  fuisse  taceretur."f 

The  Asclepions,  however,  were  not  the  only  tem- 
ples to  which  the  Greeks  resorted  for  relief  from 
sickness.  The  temples  of  Apollo,  and  of  the  other 
gods,  were  also  open  to  them,  but  only  as  places  for 
consulting  the  gods;  not,  as  at  the  Asclepions,  to 
be  subjected  to  treatment.^ 

4.  It  is  supposed  that  the  priests  of  JEsculapius, 


*  Schulze  (on  the  authority  of  Plutarch  and  others),  p.  126. 
f  Ibid  (from  St.  Augustine),  p.  126. 

1(.  Herodotus,  lib.  i.  c.  16  and  25  ;  and  Xenophon,  Memoir  of  Socrates, 
book  iii.  chapter  13.     N.  Y.  edition,  p.  576. 


DISCOUKSE.  31 

in  the  exercise  of  their  art,  were  originally  restricted 
to  these  institutions.  If  such  ever  were  the  rule,  it 
must  have  soon  been  set  aside,  or  often  disregarded. 
Hippocrates  and  his  disciples  practiced  as  periodeutse, 
or  itinerants,  in  different  parts  of  Greece.  Apol- 
lonides  of  Cos,  practiced  at  the  court  of  the  elder 
Artaxerxes.*  Euryphon  of  Cnidos,  in  consultation 
with  Hippocrates,  attended  Perdiccas,  son  of  Alex- 
ander, king  of  Macedon.f  Euryximachus  is  intro- 
duced by  Plato,  among  the  friends  of  Socrates,  as 
one  of  the  wits  and  men  of  learning  of  his  time  ;  and 
at  the  banquet  is  made  to  descant  upon  the  doc- 
trines of  his  profession,  to  enforce  the  virtue  of 
temperance  in  the  use  of  wine,  and,  at  table,  to 
prescribe  for  the  sudden  illness  of  Aristophanes. J 
Again,  we  learn  from  Xenophon,§  that  by  the  laws 
of  Lycurgus,  the  Lacedaemonian  physicians  were 
obliged  to  accompany  the  army,  to  associate  with 
the  officers,  sooth-sayers,  and  musicians ;  and,  to  be 
at  the  immediate  service  of  the  king  on  the  battle- 
fi.eld.  Xenophon  himself,  in  the  memorable  expedi- 
tion into  Persia,  was  accompanied  by  Ctesias  of  Cni- 
dos, who,  on  the  defeat  of  the  younger  Cyrus,  was 
taken  prisoner,  and  who  subsequently  rose  to  great 
distinction  as  physician  to  the  court  of  Persia ;  and 
more  so  as  the  historian  of  that  country.     In  fur- 

*  Le  Clerc,  Histoire  de  la  Medecine.     Lib.  ii.  chap.  Y,  from  Ctesias. 

f  Soranus,  in  his  Life  of  Hippocrates.  See  Kuhn's  Hippocrates,  vol.  iii. 
p.  85L 

:}:  See  the  Protagoras  and  Banquet  of  Plato,  Bohn's  edition,  vol.  ii.  p.  244, 
and  vol.  iii.  p.  482-500. 

§  Lacedtemonian  Republic,  chapter  xiii.  See  also,  Memoir  of  Socrates, 
book  i.  chapter  ii.,  N.  Y.  edition,  p.  627-8. 


32  DISCOUESE. 

ther  evidence  of  the  unrestricted  freedom  of  tlie 
Asclepiadge,  we  learn  from  the  Laws  of  Plato,*  tliat 
there  are  some  persons  physicians,  and  others  the 
ministers  of  physicians,  who  are  sometimes  also  called 
physicians.  "  Do  you  not  perceive,"  he  adds, 
^'  that  when  there  are  both  slaves  and  freemen  sick 
in  the  cities,  the  slaves  do  for  the  most  part  go 
round  and  cure  the  slaves,  or  remain  at  home  in  the 
medical  shops  ;  and  that  not  one  of  these  slave -phy- 
sicians either  gives  or  receives  any  reason  respecting 
the  diseases  of  the  slaves ;  but  as  if  knowing  accur- 
ately from  experience,  he  orders  as  if  he  were  a  self- 
willed  tyrant,  what  seems  good  to  him,  and  then 
goes  away,  bounding  off  from  one  sick  domestic  to 
another  ;  and  by  this  means,  he  affords  a  facility  to 
his  master  to  attend  to  other  patients  ?  But  the 
free-born  physician  for  the  most  part  attends  to,  and 
reflects  upon  the  diseases  of  the  free-born  ;  and  by 
exploring  these  from  the  beginning,  and  according 
to  nature,  *  *  "^  does  at  the  same  time  learn  some- 
thing from,  and,  as  far  as  he  can,  teach  something 
to,  the  sick  ;  and  does  not  order  any  thing  until  per- 
suaded of  its  propriety  ;  and  then,  after  rendering 
the  patient  gentle  by  persuasion,  he  endeavors  to 
finish  the  business  by  bringing  him  back  to  health." 

It  has  also  been  stated  that  the  Asclepiadse  were 
first  induced  to  leave  the  temples  by  the  success  of 
the  Pythagorean  physicians  after  the  breaking  up  of 
their  school,  and  their  expulsion  from  Crotona. 

The  story  of  Democedes,  already  related,  has  a 
direct  bearing  upon  this  point,  and  is  sufficient,  of 

*  Book  iv.,  c.  X. 


DISCOURSE.  33 

itself,  to  sliow  tliat  prior  to  the  dispersal  of  tlie  Py- 
thagoreans, the  cities  of  Greece  were  supplied  with 
practitioners  who  were  visiting  the  sick  at  their  own 
abodes. 

Thus,  then,  long  before  the  age  of  Pericles,  even 
before  the  Persian  war,  the  medical  men  of  Greece 
were  acquiring  a  knowledge  of  their  art  at  the 
schools  of  philosophy,  and  at  the  exercises  of  the 
gymnasia,  as  well  as  at  the  temples  ;  and  were  prac- 
ticing as  private  individuals,  as  stipendaries  at  the 
royal  courts,  or  as  public  functionaries  with  stated 
salaries,  appointed  by  the  people  ;  sometimes  in  the 
army,  sometimes  in  the  fleet ;  liberally  rewarded, 
and  held  in  high  repute.  The  custom  in  the  cities 
of  stipulating  annually  for  the  public  services  of 
medical  men,  is  a  fact  w^orthy  of  notice.  Plato  in 
the  "  Statesman,"  and  elsewhere,  alludes  to  it.  And 
his  commentator  remarks,  that  from  numerous  pas- 
sages in  this  author,  as  well  as  from  others  in  the 
writings  of  Xenophon,  Aristotle,  Strabo,  and  the 
scholiasts,  it  is  evident  there  were  at  Athens  a  body 
of  medical  men  who  were  paid  by  the  state,  as  well 
as  others  who  were  engaged  in  private  practice.* 

*  Burgess,  in  Plato.     Bohn's  edition,  vol.  iii,  p.  192. 


34:  DISCOUESE 


CHAPTER    III. 


THE    ASCLEPIAD^. 


The  course  of  education  among  the  Asclepiadse, 
was  in  conformity  with  the  national  habits.  The 
youth  who  were  destined  for  the  profession,  if  not 
the  sons  of  the  initiated,  were  probably  not  allowed 
to  begin  until  after  the  completion  of  their  prepara- 
tory education,  from  their  seventeenth  to  the  twen- 
tieth year.  But  the  sons  of  physicians  began  earlier, 
and,  with  both,  the  course  of  training  probably  con- 
tinued to  the  close  of  their  twenty-fifth  year. 

The^-neophyte  was  inducted  into  his  art  with  all 
the  secrecy  and  exclusiveness  which,  from  the  remo- 
test ages,  had  prevailed  among  the  handicraft  as- 
sociations, the  religious  orders,  and,  at  a  later  pe- 
riod, in  the  political  clubs,  and  even  in  the  schools 
of  philosophy.  For,  as  at  Athens,  so  in  all  the  other 
states,  these  unions,  mysteries,  or  secret  associations, 
were  innumerable.  Some  of  them  were  for  charit- 
able purposes,  some  of  them  for  traffic,  some  for  the 
cultivation  of  knowledge  ;  and  some,  as  among  our- 
selves, were  secret  organizations  for  controlling  the 
affairs  of  the  people.  The  ceremony  of  initiation 
into  them,  varied  somewhat  with  the  chara^cter  and 
object  of  each  ;  but  from  the  few  hints  preserved 
respecting  them,  there  is  reason  to  believe  that  in 
all  of  them  it  was  modeled,  as  nearly  as  possible, 
after  that  of  the  Eleusinian  and  Dionysian  Mysteries. 


DISOOTJESE.  35 

Of  the  Mysteries  of  Eleusis,  there  were  two  or- 
-ders,  the  less  and  the  greater.  The  less  were  the 
most  essential,  and  consisted  of_thr.ee  grades.  The 
ceremony  for  the  first  grade  was  styled  Illumination 
or  the  Tradition  of  the  Sacred  Rites  ;  that  for  the 
second  was  styled  Inspection,  or  the  Looking-on  ; 
and  that  for  the  third,  which  was  the  end  and  de- 
sign of  the  other  two,  was  called  the  Binding  of  the 
Head,  or  Coronation.  But  according  to  the  greater 
order,  there  were  two  additional  ceremonies  ;  name- 
ly, the  introductory,  which  was  called  Purification  ; 
and  the  ultimate,  which  was  called  Friendship  with 
the  Deity. 

For,  of  those  who  sought  to  engage  in  these  mys- 
teries, all  were  not  admissible  ;  there  being  certain 
^aracters  excluded  by  the  voice  of  the  crieT,_  such 
as  those  of  impuLreJiands  or  inarticulate_voice.  So 
that  before  admission,  each  candidate  underwent  the 
ceremony  of  Purification.  The  two  succeeding  cere- 
monies were  strictly  progressive  ;  but  the  Binding 
of  the  Head,  or  Coronation,  signified  the  full  recep- 
tion of  those  who  were  thus  honored,  and  that  they 
could  afterwards  communicate  to  others  the  sacred 
rites ;  or  officiate  as  torch-bearers,  or  interpreters ; 
or  sustain  any  other  part  in  the  sacred  offices.  The 
fifth  degree,  or  Friendship  with  the  Deity,  was  a  re- 
sult reached  only  after  many  years  of  active  service 
by  those  who  had  attained  the  highest  perfection  in 
their  respective  occupations. 

In  the  political  clubs,  and  in  the  schools  of  phi- 
losophy, the  cei^mony  of  Purification,  which  in  the 
figurative  language  of  Einpedocles,  was  the  act  of 


36  DISCOURSE. 

drawing  from  tlie  ^ve  fountains  witli  an  indissoluble 
vessel  of  brass,  liad  reference  to  elementary  training 
in  arithmetic,  geometry,  stereometry,  music,  and  as- 
tronomy. After  such  preparation  in  the  schools  of 
philosophy,  came ;  first,  Illumination,  or  the  study 
of  theorems,  logical,  political,  and  philosophical ;  in 
other  words,  the  study  of  abstract  principles.  The 
next  stage  of  advancement,  or  as  it  was  called,  In- 
spection, had  reference  to  practical  studies,  or  what 
Plato  calls  "  intelligibles,  true  beings,  and  ideas." 
But  the  last  stage,  or  Coronation,  was  the  closing 
ceremony  of  education,  and  imparted  to  the  recip- 
ient the  right  of  leading  others  to  the  subjects  of  his 
own  contemplation.* 

These  three  essential  stages  of  advancement  an- 
swered to  the  three  scholastic  degrees  in  the  univer- 
sities of  the  middle  ages,  and  to  the  three  degrees 
among  free-masons ;  with  both  of  whom  the  cere- 
monies were  in  fact  derived  from  those  of  the  early 
mysteries.  And,  we  are  told  by  Mr.  Burgess,  that 
the  Crowning,  or  Binding  of  the  head,  never  took 
place  before  the  comj^letion  of  the  fifth  year.f 

Now,  to  return  to  the  Asclepiad^e ;  it  is  clear  that 
the  youth  in  the  course  of  initiation,  submitted  to 
observances,  and  advanced  by  gradations,  analogous 
to  those  of  the  other  secret  associations.  For  we  are 
expressly  informed  by  Hippocrates,  J  in  reference  to 
his  own  profession,  that  "  Things  which  are  sacred 
are  to  be  imparted  only  to  sacred  persons ;"  and  that 


*  Thos.  Taylor.     Eleusinian  and  Bacchic  Mj^teries,  p.  48-62. 
f  In  Plato.     Bohn's  edition,  toI.  iil  p.  549. 
:}:  In  the  Law. 


DISCOTJESE. 


"  it  IS  unlawful  to  impart  them  to  the  profane  until 
after  their  initiation  into  the  mysteries  of  the  sci- 
ence." With  reference  to  Purification,  or  the  train- 
ing which  should  precede  Illumination,  he  says, — 
"  Whoever  is  to  acquire  a  competent  knowledge  of 
medicine,  ought  to  possess  the  following  advantages : 
a  natural  disposition,  instruction,  a  favorable  posi- 
tion for  study,  early  tuition,  love  of  labor,  leisure.""^ 
And,  writing  to  his  son,  the  author  of  the  Hippo- 
cratic  Letters,  says,  "  Give  due  attention,  my  son,  to 
Geometry  and  Arithmetic.  For  such  studies  will 
not  only  render  your  life  illustrious  and  useful  to 
your  fellow-beings ;  but  your  mind  more  acute  and 
perspicacious  in  arriving  at  fruitful  results  in  every 
thing  pertaining  to  your  art."f 

The  candidate  having  passed  the  first  ordeal  of 
preparation,  and  commencing  the  ceremonies  of  Illu- 
mination, was  obliged  to  subscribe  to  the  Oath ; 
which  was  a  formula  analogous  to  that  which  was 
enjoined  among  the  Pythagoreans,  and  was  in  the 
following  words : 

"  I  swear  by  Apollo,  the  physician,  by  ^scu- 
lapius,  by  Hygeia,  Panacea,  and  all  the  Gods  and 
Goddesses,  that  according  to  my  ability  and  judg- 
ment, I  will  keep  this  oath  and  stipulation,  to  reckon 
him  who  teaches  me  this  art  equally  dear  to  me  as 
my  parents,  to  share  my  substance  with  him,  and 
relieve  his  necessities  if  required ;  to  look  upon  his 
offspring  on  the  same  footing  as  my  own  brothers, 


*  In  the  Law. 

f  Kuhn's  edition,  vol.  iii.  p.  822. 


38  DISCOIJRSE. 

and  to  teacli  them  this  art,  if  they  shall  wish  to 
learn  it,  without  fee  or  stipulation  ;  and  that  by 
precept,  lecture,  and  every  other  mode  of  instruc- 
tion, I  will  impart  a  knowledge  of  this  art  to  my 
own  sons,  to  those  of  my  teachers,  and  to  disciples 
bound  by  a  stipulation  and  oath  according  to  the 
law  of  medicine,  but  to  none  others.  I  will  follow 
that  system  of  regimen  which,  according  to  my  abil- 
ity and  judgment,  I  consider  for  the  benefit  of  my 
patients ;  and  abstain  from  whatever  is  deleterious 
and  mischievous ;  I  will  give  no  deadly  medicine  to 
any  one,  if  asked ;  nor  suggest  any  such  counsel ; 
and  in  like  manner,  I  will  not  give  a  woman  a  pes- 
sary to  produce  an  abortion.  With  purity  and  with 
holiness  I  will  pass  my  life  and  practice  my  art.  I 
will  not  cut  persons  laboring  under  the  stone,  but 
will  leave  this  to  be  done  by  men  who  are  practi- 
tioners of  this  work.  Into  whatever  houses  I  enter, 
I  will  go  into  them  for  the  benefit  of  the  sick,  and 
will  abstain  from  every  voluntary  act  of  mischief 
and  corruption  ;  and,  further,  from  the  seduction  of 
females  and  males,  of  freemen  and  slaves.  What- 
ever, in  connection  with  my  professional  practice,  or 
not  in  connec-feion  with  it,  I  see  or  hear,  I  will  not 
divulge,  as  reckoning  that  all  such  should  be  kept 
secret.  While  I  continue  to  keep  this  oath  inviolate, 
may  it  be  granted  to  me  to  enjoy  life  and  the  prac- 
tice of  my  art,  respected  by  all  men  at  all  times  ! 
But  should  I  trespass  and  violate  this  oath,  may  the 
reverse  be  my  lot  !"^ 

*  Adams'  Hippocrates,  vol.  ii.,  p.  779. 


DISCOURSE.  39 

The  pupil  tlius  admitted,  proceeded  next  to  the 
ordinary  business  of .  Illumination,  which  consisted 
in  committing  to  memory  certain  traditionary  pre- 
cepts ;  in  listening  to  the  prelections  of  the  instruc- 
tor ;  in  the  contemplation  of  diseases  within  the 
temples,  or  at  the  bed-side  of  the  sick ;  in  combining 
the  knowledge  thus  obtained  with  some  general  ac- 
quaintance with  the  rules  of  health ;  and  where  the 
preparatory  training  in  the  accessory  sciences  had 
not  already  been  completed,  in  acquiring  a  knowl- 
edge of  these,  and  of  the  higher  philosophy  of  the 
day* 

The  business  of  Inspection,  which  was  next  in 
order,  and  which,  in  philosophy,  was  "an  occupation 
about  intelligibles,  true  beings,  and  ideas,"  immedi- 
ately preceded  Coronation ;  and,  as  iu  philosophy, 
had  relation  to  practical  subjects,  probably  the 
treatment  of  disease  under  the  immediate  supervi- 
sion of  the  instructor.  The  ceremony  of  Coronation 
took  place  at  the  completion  of  the  term  of  study, 
and  corresponded  with  the  modern  ceremony  of 
Graduation.  It  was  in  evidence  of  the  recipient's 
fitness  for  assuming  the  duties  of  his  profession,  it 
conferred  upon  him  the  privileges  of  fellowship, 
and,  as  a  master  of  his  art,  the  right  of  initiating 
others  into  its  sacred  mysteries. 

It  is  here  worthy  of  remark,  that  the  ceremony  of 
placing  a  wreath,  cap,  or  crown,  upon  the  head  of 
those  who  were  admitted  into  full  fellowship  at 
these  ancient  schools,  was  continued  down  to  the 


Littre,  Introduction,  (Euvres  d'Hippocrate. 


40  DISCOUKSE. 

period  of  the  Middle  Ages.  It  was  the  usual  form  of 
admission  at  Salernum,  the  earliest  of  the  medieval 
schools  of  medicine.  The  ceremony  was  also  the 
same  at  the  school  of  Paris,  the  regulations  of  which 
were  adopted  in  full  from  those  of  the  Salernian  in- 
stitution. At  Paris,  as  at  the  other  universities,  the 
cap  or  bonnet  was  substituted  for  the  wreath.  But 
even  at  the  temples  the  cap  may  have  occasionally 
been  used.  The  statues  of  the  ancients  usually  rep- 
resent the  head  uncovered.  And  some  have  been  at 
a  loss  to  know  why  the  head  of  Hippocrates  !s  some- 
times seen  covered  with  a  cap.  The  ceremonies  of 
his  school,  if  more  minutely  understood,  might,  per- 
haps, be  sufficient  to  explain  this. 

As  a  rational  study,  so  long  as  medicine  was 
taught  orally,  or  by  tradition  and  example  only,  the 
acquirements  of  its  votaries  could  not  have  been  ex- 
tensive. Their  main  study  in  the  management  of 
acute  diseases,  was  in  regulating  the  regimen.  Epi- 
demic diseases  they  looked  upon  as  divine  dispensa- 
tions, with  which  they  did  not  dare  to  interfere.  A 
knowledge  of  the  general  rules  of  health,  and  the 
influence  of  diet,  exercise,  climate,  and  locality,  at- 
tracted much  of  their  attention.  In  the  manage- 
ment of  injuries  and  external  diseases,  they  were 
but  little  inferior  to  their  descendants  of  modern 
times.  Their  medical  agents  were,  the  lancet,  of 
which  they  made  frequent  use  ;  certain  active  cath- 
artics, emetics,  and  diuretics ;  cataplasms,  unguents, 
escharotics  ;  and  mechanical  instruments  and  appli- 
ances. Of  anatomy  and  physiology  their  knowledge 
was  limited ;  and  as  for  chronic  diseases,  up  to  the 


DISCOURSE.  41 

time  of  Herodicus  of  Selymbria,  who  is  said  to  liave 
been  one  of  tlie  teachers  of  Hippocrates,  they  did 
not  venture  to  interfere  with  them. 

This  Herodicus  had  been  a  teacher  of  youth,  and 
being  always  in  delicate  health,  he  had  prolonged 
his  life  by  systematic  exercises  and  a  regulated  diet. 
The  treatment  which  he  had  found  useful  in  his  own 
case,  he  recommended  to  others ;  and  thus  he  turned 
the  attention  of  medical  men  to  a  course  of  practice, 
and  a  group  of  diseases,  which  they  had  hitherto 
disregarded.     His  innovations  were  for  a  time  un- 
popular ;  and  even  Plato  undertakes  to  upbraid  him 
for  them,  declaring   "  that   no   attempt   should  be 
made  to  cure  a  thoroughly  diseased  system,  and  so 
to  afford  a  long  and  miserable  life  to  the  man  him- 
self, as  well  as  to  his  descendants.    For  JEsculapius," 
he  continues,  "  did  not  think  a  man  ought  to  be 
cured  who  could  not  live  in  the  ordinary  course,  as 
in  this  case  he  would  be  of  no  service  to  himself  or 
to  the  state."     He  goes  on  to  deplore  the  necessity 
of  using  the  terms  then  recently  invented  for  desig- 
nating chronic  diseases  : — "  Dropsies,  and  Catarrhs  ! 
Do  not  you  think  these  abominable  1     Truly  these 
are  very  strange  names  of  diseases  ;  such,  I  think,  as 
existed  not  in  the  days  of  ^sculapius."*    But  though 
not  in  the  habit  of  treating  chronic  internal  ailments, 
the  profession  were  at  least  supposed  to  be  acquaint- 
ed with  them,  so  far  as  to  be  able  to  detect  them, 
and  pronounce  correctly  in  regard  to  them,  in  the 
inspection  of  slaves.     Even  Plato  would  hold  the 
physician  responsible  for  his  opinion  in  such  cases, 

*  Republic.    Book  iil  c.  14. 


42  DISCOURSE. 

the  object  of  tlie  philosopher  being  to  guard  against 
dishonesty  in  the  sale  or  transfer  of  slaves  from  one 
master  to  another."^ 

With  respect,  then,  to  the  policy  and  ethics  of  the 
Asclepiadse,  we  learn  from  the  Oath  and  Law,  aa 
also  from  other  passages  in  the  Hippocratic  code, 
that  the  student  was  formally  bound  to  his  master 
by  indentures  ;  that  the  son  of  a  former  master, 
choosing  to  enter  the  profession,  received  his  educa- 
tion gratuitously ;  that  others  not  thus  circumstan- 
ced, were  expected  to  pay  for  their  instruction ;  that 
the  sons  of  the  Asclepiadse  did  not  necessarily  follow 
their  fathers'  employment ;  that  those  who  were 
employed  in  the  temples,  or  in  practice  elsewhere, 
were  therefore,  simply  a  fraternity,  in  the  modern 
acceptation  of  that  word,  and  not,  as  some  suppose, 
an  exclusive  caste  derived  from  one  family  ;  that 
each  practitioner  was  at  liberty  to  follow  his  occu- 
pation where  and  when  he  chose,  but  for  honorable 
purposes  only ;  and  that  even  at  this  early  day,  there 
were  designing  men  who  were  ^'  physicians  only  in 
name,"  and  who  gave  themselves  up  to  disreputable 
practices  ;  against  whom  the  regularly  initiated  had 
no  redress,  and  no  other  advantage  than  that  upon 
which  we  ourselves  rely,  a  superior  education,  hon- 
esty of  purpose,  devotion  to  their  duties,  and  the 
confidence  of  a  discerning  public. 

Many  of  the  self-imposed  restrictions  of  the  Ascle- 
piadse  had  reference  to  the  evil  doings  of  the  medi- 
cal impostors  of  their  own  times.  M.  Littre  leads  us 
to   suppose  that  the  injunction  against   lithotomy 

*  Laws.     Book  xi.  c.  2. 


DISCOURSE.  43 

may  have  referred  to  the  mutilating  process  of  cas- 
tration, which  had  been  from  time  immemorial  in 
use  among  the  Asiatics,  as  it  was  afterwards  among 
the  Greeks  and  Romans,  and  which  was  in  the  hands 
of  a  special  class  of  manipulators,  as  it  is  known  also 
to  have  been  in  Southern  Europe,  in  comparatively 
recent  times.'^  The  remarks  of  Paulus  ^gineta  in 
reference  to  this  operation,  are  somewhat  in  con- 
firmation of  M.  Littre's  views.  Again,  the  prohibi- 
tion against  the  sale  and  administration  of  poisons, 
is  clearly  in  reference  to  those  who  are  known  to 
have  been  engaged  in  such  traffic, — particularly  the 
Agurtse,  itinerant  mountebanks,  or  pedler-priests 
as  Plato  calls  them,  who  went  about  imposing  on  the 
unwary,  and  cheating  them  by  lying  prophecies.f 

But  some  of  these  restrictions  doubtless  arose 
from  the  suggestions  of  prudence.  It  has  been  re- 
marked by  Mr.  Adams,  that  professional  virtue 
among  the  ancients  never  arose  to  the  degree  of 
disinterestedness  recommended  by  Sydenham ;  who 
maintains  that  the  physician  ought  to  be  always 
ready  to  serve  his  patient,  even  at  the  risk  of  his  own 
reputation.  J  Sydenham,  however,  wrote  as  a  mem- 
ber of  a  Christian  community,  and  knew  that  where 
his  motives  were  unimpeachable,  and  his  conduct 
that  of  an  honorable,  attentive,  and  skillful  physi- 
cian, his  want  of  success  in  the  management  of  a 
critical  case,  was  not  likely  to  injure  his  reputation 
as  a  man.     But  the  physician  of  early  Greece  had 


*  Renouard.     Histoire  de  la  Medicine.     Paris,  1846,  tome  2,  p.  288. 
f  Republic.     Book  ii.  c.  Y.  X  Adams's  Hippocrates,  vol.  ii.  p.  641. 


4:4:  DISC0UK8E. 

more  at  risk  than  reputation,  sometimes  even  life  * 
By  custom,  if  not  by  written  law,  lie  was  in  some 
measure  personally  accountable  for  tlie  want  of  suc- 
cess in  what  he  undertook.  The  usages  of  the  times 
imposed  upon  him  circumspection,  as  well  as  fore- 
cast. Hence  the  injunction  which  he  was  required 
to  observe,  not  to  undertake  the  care  of  unmanage- 
able diseases  ;  or,  if  induced  to  take  charge  of  them, 
to  give  timely  notice  of  their  probable  result.  There 
was  no  want  of  liberality  in  this  ;  and  it  is  not  for 
us  to  complain  of  that  habitual  caution  which  led 
to  the  close  and  attentive  study  of  prognostics,  a 
class  of  studies  for  which  we  have  still  reason  to  be 
thankful  to  the  Greeks. 

With  regard  to  social  rank  among  the  Asclepi- 
adse,  it  was  in  proportion  to  personal  merit,  rather 
than  to  any  artificial  status.  But  owing  to  the  great 
number  of  pretenders,  the  regularly  initiated  were, 
then  as  now,  disposed  to  look  upon  themselves  as 
sufferers  by  the  consideration  occasionally  bestowed 
upon  impostors.  "  Medicine,"  says  Hippocrates,  "  is 
of  all  the  arts,  the  most  noble ;  but,  owing  to  the 
ignorance  of  those  who  practice  it,  and  of  those  who 
inconsiderately  form  a  judgment  of  these,  it  is  at 
present  far  behind  all  other  arts.  Their  mistake," 
he  adds,  "  appears  to  me  to  arise  principally  from 
this,  that  in  the  cities  there  is  no  punishment  con- 
nected with  the  practice  of  medicine,  and  with  it 
alone,  except  disgrace ;  and  that  does  not  hurt  those 


*  Plato.     Laws,  book  xi.  c.  12.    Galen,  toI.  xiv.,  p.  602,  Kuhn's  edition. 
Corpus  Juris  Civilis,     Julii  Paulii  Recept.  Sentent     Lib.  v.  tit.  xxiii.,  §  13. 


DISCOUESE.  45 

who  are  familiar  witli  it.  Such  persons  are  like  the 
figures  which  are  introduced  in  tragedies :  for,  as 
they  have  the  shape,  and  dress,  and  personal  ap- 
pearance of  actors,  and  are  not  actors,  so  also  phy- 
sicians are  many  in  title,  but  very  few  in  reality  * 

Such,  then,  was  the  condition  of  our  profession  in 
Greece  up  to  the  period  at  which  it  fairly  emerged 
from  the  traditionary  lore  of  the  temples,  and  as- 
sumed its  position  as  a  rational  and  progressive 
science.  The  honor  of  effecting  this  change,  the 
world  has  ascribed  to  Hippocrates. 


CHAPTER     IV. 

HIPPOCRATES   AND   HIS    IMMEDIATE   SUCCESSOES. 

Of  the  personal  history  of  Hippocrates,  we  know 
but  little.  He  was  born  in  the  year  460  before  the 
birth  of  Christ,  and  was,  consequently,  a  few  years 
older  than  Plato,  and  younger  than  Socrates.  He 
received  his  professional  education  under  his  father, 
Heraclides,  at  the  Asclepion  of  Cos ;  and  we  are  told 
that  in  his  youth,  at  Athens  and  elsewhere,  he  had 
the  benefit  of  the  ablest  masters  in  science  and  phi- 
losophy;  among  whom  were  the  sophist  Gorgias,  and 
the  hygienist  Herodicus,  of  Selymbria.  It  is  also 
said  that  he  studied  under  Democritus  of  Abdera ; 
or,  as  some  suppose,  Heraclitus.     After  the  death  of 

*  The  Law.     Adams's  Hippocrates,  vol.  ii.,  p.  784. 


46  DISCOIJESE. 

his  father,  in  accordance  with  the  custom  of  the  phi- 
losophers and  physicians  of  that  epoch,  he  traveled 
over  many  countries  ;  and  afterwards,  in  the  pursuit 
of  his  profession,  spent  much  time  in  the  cities  of 
Macedonia,  Thrace,  and  other  parts  of  Greece.  At 
Athens,  about  the  time  of  the  Peloponnesian  war, 
his  reputation  was  such,  either  for  the  professional 
services  rendered  to  that  city  in  relieving  it  of  an 
epidemic,  or  for  having  refused  to  assist  the  enemies 
of  his  country  when  solicited  to  do  so  by  Artaxerxes, 
that  it  was  decreed  that  he  should  be  initiated  into 
the  Mysteries  of  Eleusis,  that  he  should  enjoy  the 
right  of  citizenship,  that  he  should  be  supported  in 
the  Prytaneum  at  the  public  expense,  that  he  should 
be  honored  with  a  golden  crown,  and  that  all  the 
children  born  at  Cos,  his  native  island,  might  pass 
their  youth  at  Athens,  where  they  should  be  treated 
as  the  offspring  of  Athenian  citizens.  H  ow  much  of 
his  time  may  have  been  spent  in  the  city  where  he 
was  thus  distinguished,  has  not  been  ascertained ; 
but  his  most  protracted  residence  was  at  Larissa 
and  other  cities  of  Thessaly,  where  he  spent  his  lat- 
ter days,  and  where  he  died,  at  the  advanced  age  of 
eighty-five  or  ninety  years.* 

Many  speculations  have  been  offered,  to  account 
for  the  rapid  advancement  of  medicine  in  the  hands 
of  this  great  father  of  the  profession.  According  to 
Celsus,  his  principal  credit  was  in  removing  the  teach- 
ing of  medicine  from  the  schools  of  philosophy, 
where  it  had  always  received  some  attention,  and 

*  Soramis.  Genua  et  Vita  Hippocratis.  See  Kuhn's  Hippocrates,  vol. 
iii.,  p.  850. 


DI8C0UESE.  47 

treating  of  it  apart,  as  a  distinct  department  of 
practical  knowledge.  Pliny,*  after  Yarro,  supposes 
tliat  lie  was  tlie  first  to  institute  clinical  instruction, 
"  hanc  qucB  Olinicce  vocatur^^''  tliat  lie  was  led  to  this 
after  tlie  burning  of  the  temple  of  Cos,  and  that  the 
materials  of  his  course  were  supplied  mainly  by  the 
votive  tablets  which  had  been  there  accumulating. 
But  his  claim  to  our  respect  rests  on  higher  ground. 

The  great  among  mankind  are  not  merely  those 
who  set  the  first  examples.  Examples  are  often  the 
result  of  accident ;  and  the  Fest  of  them,  in  a  prac- 
tical point  of  view,  rarely  the  result  of  forethought. 
He  who  detects  the  rising  spirit  of  the  age,  who  first 
gives  expression  and  enxbodiment,  or  the  power  of 
progress  and  enduran^ie^o  the  wisdom,  feelings, 
aspirations,  customs,  or  hitherto  undivulged  opinions 
of  his  times,  is  even  mor£  worthy  of  regard  than  the 
innovator.  Such  a  man  was  Hippocrates.  He  lived 
in  an  age  of  progress.  The  earliest  historians,  the 
earliest  and  ablest  dramatists,  the  profoundest  phi- 
losophers, the  wisest  legislators,  the  ablest  generals, 
the  greatest  architects,  painters,  and  sculptors  of 
Greece,  were  all  men  of  the  same  epoch.  And  while 
other  arts  and  sciences  were  thus  springing  into  life, 
and  rising  at  once  to  maturity,  it  is  not  surprising 
that  some  man  of  genius  should  appear  in  the  ranks 
of  medicine,  to  give  to  its  principles  form  and  utter- 
ance.    This  man  was  Hippocrates. 

He  was  not,  then,  the  inventor  of  the  healing  art, 
nor  of  the  modes  of  teaching  it.     He  was  not  the 

*  Hist.  Nat.    Lib.  xxix.,  cap.  i. 


48 


DISCOURSE 


first  to  write  upon  it.  But  familiar  with  its  tra- 
ditionary lore,  with  the  science  and  philosophy  of 
his  day,  and  with  the  practical  details  of  his  pro- 
fession in  all  its  bearings,  he  was  the  first  to  com- 
bine such  knowledge  in  systematic  form,  and  to  give 
to  it  a  scientific  value  ;  yet  not  so  clearly  scientific,  as 
to  be  sufficient  of  itself,  in  the  form  in  which  he  left 
it,  and  independent  of  oral  comment  or  practical 
illustration,  to  qualify  the  aspirant  who  would  avail 
himself  of  it  alone,  for  the  proper  exercise  of  his 
calling.  "  The  more  I  become  familiar  with  the 
Hippocratic  books,"  says  M.  Littre,*  "  the  more  I  am 
convinced  that  they  were  prepared  with  reference 
to  the  accompaniment  of  oral  instruction,  without 
which  even  the  clearest  of  them  are  both  obscure 
and  incomplete." 

Yet  these  books  opened  to  the  learned  much  that 
had  hitherto  been  taught  in  full  only  to  the  initi- 
ated, and  paved  the  way  for  the  more  exact  and 
rational  study  of  medicine  as  a  liberal  art.  The  loss 
of  respect  for  the  mysteries  of  the  temples  was  after- 
wards in  proportion  to  the  general  diffusion  of  correct 
knowledge.  The  schools  of  Cnidos  and  Cos  had  now 
entered  upon  the  cultivation  of  medicine  as  a  sci- 
ence ;  and  with  them  were  associated  not  only  the 
family  descendants  of  this  great  man,  but  also  most 
of  the  distinguished  names  in  the  profession  between 
the  days  of  Hippocrates  and  the  founding  of  the 
Alexandrian  Museum. 

Among  the  writings  attributed  to  Hippocrates,  it 

*  CEuvres  d'Hippocrat,  tome  iv,  p.  625. 


DISCOUESE.  49 

is  difficult  to  determine  wliat  portion  was  written  by 
himself,  and  wliat  by  his  immediate  disciples.  On 
this  point  the  critics  have  never  been  able  to  agree. 
By  Erotian  and  Galen  many  works  were  accepted 
as  his  which  the  moderns  are  disposed  to  refer  to 
other  writers.  Foes,*  to  whom  we  are  indebted 
for  a  most  careful  Latin  version  of  the  whole  collec- 
tion, was  willing  to  accept  as  genuine  all  works  pro- 
nounced to  be  such  by  the  ancients  ;  but  the  later 
critics  have  not  so  readily  deferred  to  ancient  au- 
thority. 

According  to  Mercuriali,f  not  more  than  fourteen 
treatises  out  of  the  whole  collection  were  published 
by  Hippocrates  himself.  Five  others,  according  to 
the  same  critic,  may  have  been  left  by  him  unfinished, 
to  be  completed  either  by  his  son-in-law  and  suc- 
cessor, Polybius,  by  his  sons  Thessalus  and  Draco, 
by  his  grandson  Hippocrates,  or  by  other  members 
of  his  family.  A  third  portion,  including  about 
twenty-two  treatises,  though  perhaps  not  even  begun 
by  Hippocrates,  is  in  strict  accordance  with  his  doc- 
trines, and  is  believed  by  Mercuriali  to  have  ema- 
nated from  the  immediate  descendants  of  Hippo- 
crates or  other  disciples  of  the  school  of  Cos.  The 
remaining  portion  of  the  collection,  according  to  the 
same  authority,  consists  of  spurious  writings,  and  of 
such  as  contain  opinions  not  in  accordance  with  the 
doctrines  of  Hippocrates,  though  published  as  his. 

*  Magni  Hippocratis  Opera  omnia  quse  extant,  in  sectiones  octo  ex 
Erotiani  mente  distributa,  nunc  recens  Latina  interpretatione  et  annota- 
tionibus  illustrata,  Anutio  Faesio  auctore.     2  vols.  fol.     Frankfort,  1596. 

f  See  Schulze,  p.  215. 


50  DISCOURSE. 

Other  distributions  of  tliese  works  have  since  been 
made,  by  Haller,  Gruner,  Schulze,  Ackermann, 
Grimm,  Sprengel,  Link,  Peterson,  and  other  writers. 

M.  Littre,*  after  a  most  careful  and  searching  ex- 
amination of  the  whole  collection,  distributes  the 
various  works  composing  it  into  eleven  classes,  plac- 
ing in  class  first  the  thirteen  treatises  which  are  be- 
lieved to  be  from  the  pen  of  Hippocrates.  These 
are,  1st, — the  book  on  Ancient  Medicine;  2d,  the 
Prognostics ;  3d,  the  Aphorisms ;  4th,  the  Epi- 
demics, first  and  third  books ;  5th,  Regimen  in 
Acute  Diseases;  6th,  on  Air,  Water,  and  Places; 
Yth,  on  Articulations ;  8th,  on  Fractures ;  9th,  the 
Mochlicus,  or  Instrument  for  reducing  Luxations, 
&c. ;  10th,  the  Physician's  OfiSce  ;  11th,  Injuries  of 
the  Head  ;  12th,  the  Oath  ;  13th,  the  Law. 

The  works  of  the  second  class  he  attributes  to 
Polybius.  These  are,  the  book  on  the  Nature  of 
Man,  and  that  on  Eegimen  for  Persons  in  Health. 
In  the  third  class  he  includes  two  books  which  he 
believes  to  be  more  ancient  than  the  genuine  writ- 
ings. These  are  the  Coan  Praenotions  and  the  first 
book  of  Prorrhetics.  In  class  fourth,  he  places  cer- 
tain works  which  he  cannot  on  undisputed  authority 
assign  to  Hippocrates,  but  which  may  have  ema- 
nated front  his  school.  These  are  the  treatises  on 
UlcerS;  on  Fistulse  and  Hemorrhoids,  on  Pneuma,  on 
the  Sacred  Disease,  on  the  Places  in  Man,  on  Art, 
on  Kegimen  and  Dreams,  on  Affections,  on  Internal 
Affections ;    on   Diseases,    first,   second,   and   third 

*  Loco  citato,  chap.  xii. 


DISCOUESE.  51 

books  ;  on  tlie  Seventh  Montli  Foetus,  on  the  Eighth 
Month  FcBtus.  In  the  fifth  class  he  includes  such 
works  as  appear  to  be  merely  collections  of  notes,  or 
extracts  from  other  of  the  genuine  writings :  these 
are  the  second,  fourth,  fifth,  sixth,  and  seventh 
books  on  Epidemics,  the  book  on  Humors,  that  on 
the  use  of  Liquids,  and  perhaps  the  Physician's  Office, 
which  is  also  mentioned  in  the  first  class. 

In  class  sixth  he  places  several  books  by  some 
nnknown  author,  who  must  have  written  earlier  than 
Aristotle,  and  whose  writings  form  a  special  series 
in  the  collection.  These  are  the  treatises  on  Gener- 
ation, on  the  Nature  of  the  Infant,  Diseases — fourth 
book,  the  Diseases  of  Women,  the  Diseases  of  Young 
Women,  on  Unfruitful  Women.  In  class  seventh 
he  places  the  treatise  on  Superfoetation  which,  on 
the  authority  of  Aristotle,  he  is  disposed  to  ascribe 
to  Leophantes.  His  eighth  class  is  made  up  of 
works  which  appear  to  have  been  written  about  the 
time  of  Aristotle  and  Praxagoras ;  and  which  he  con- 
siders to  have  been  of  this  epoch,  either  because 
they  make  allusion  to  the  pulse ;  or  because,  in  ac- 
cordance with  the  teaching  of  Aristotle,  they  refer 
the  origin  of  the  blood-vessels  to  the  heart ;  or  be- 
cause, by  Erotian,  Galen,  or  other  of  the  ancient 
critics,  they  have  been  pronounced  to  be  more  recent 
than  the  time  of  Hippocrates.  These  are  treatises 
or  fragments  on  the  Heart,  on  Aliment,  on  Fleshes, 
on  the  Weeks,  the  second  book  on  Prorrhetics,  on 
the  Glands,  and  an  extract  from  the  compilation  on 
the  Nature  of  Bone. 

In  class  ninth  he  places  several  small  treatises, 


52  DISCOUESE. 

fragments,  or  compilations,  whicli  do  not  appear  to 
liave  been  mentioned  by  the  ancient  critics  or  com- 
mentators. These  are,  on  the  Physician,  on  Honor- 
able Conduct,  the  Precepts,  on  Anatomy,  on  Den- 
tition, on  the  Nature  of  Woman,  on  Excision  of  the 
Foetus,  the  eighth  section  of  Aphorisms,  on  the  Na- 
ture of  Bone,  on  Crises,  on  Critical  Days,  on  Pur- 
gative Medicines,  on  Vision.  In  class  tenth  he  intro- 
duces a  notice  of  such  works  as  formerly  belonged 
to  the  collection,  but  which  are  now  lost.  These 
were,  the  book  on  Dangerous  Wounds,  that  on 
Missiles  and  Wounds,  and  the  first  book  on  Dis- 
eases— the  less.  In  the  last  class  he  places  the 
Letters,  Decree,  and  Discourse ;  which,  though  very 
ancient,  are  not  the  less  apocryphal.  These  are,  the 
Letter  and  Decree  concerning  the  Plague,  the  Let- 
ters relating  to  the  Madness  of  Democritus,  the 
Letter  from  HijDpocrates  to  his  son  Thessalus,  and 
the  Discourse  relative  to  the  war  between  the 
Athenians  and  the  people  of  Cos. 

The  classification  adopted  by  Dr.  Greenhill,  of  Ox- 
ford, and  Mr.  Francis  Adams,*  the  English  translator 
of  Hippocrates,  does  not  materially  differ  from  the 
foregoing  so  far  as  relates  to  the  writings  of  Hippo- 
crates and  of  his  immediate  family  and  disciples; 
though  Mr.  Adams  believes  that  M.  Littre,  in  re- 
jecting certain  portions  of  the  eighth  class,  has  under- 
estimated the  anatomical  knowledge  of  the  sage  of 
Cos,  and  he  gives  good  reasons  for  this  opinion. 

In  examining  the  collection  with  reference  to  its 

*  Genuine  Works  of  Hippocrates,  vol.  i.  p.  46. 


DISCOURSE.  53 

doctrines,  we  find  Hippocrates  in   the  first   place 
investigating  tlie   influence  of  surrounding  circum- 
stances  on   the   health  and  diseases  of  the   living 
body.     In  the  book  on  Ancient    Medicine  he  op- 
poses those  who  would  attribute  all  diseases  to  a 
single  cause,  whether  heat  or  cold,   or  dryness  or 
moisture.     He  founds  his   system  on  realities — ^on 
observation,  the  records  of  science,  and  the  deduc- 
tions of  sound  reasoningy  Adopting  from  the  schools 
of  philosophy  the  doctnne  of  the  primitive  elements, 
and  that  of  the  primitive  humors  which  was  derived 
from  this,  he  sees  in  the  human  body  the  humors 
undergoing   changes   in   accordance   with  the  con- 
ditions of  health  and  disease.     He  is  led  to  believe 
that  health  is  maintained  by  the  equable  proportion 
and  intermixture  of  the  humors,  and  that  disease  is 
the  result  of  their  inequalities.    He  admits  that  dur- 
ing their  changes  the  disordered  humors  undergo  a 
process  of  coction  by  which  they  may  be  restored 
to  their  healthy  condition  ;  and  as  time  is  requisite 
for  effecting  this  process  he  undertakes  to  show  how 
the   critical   discharge  is   brought    about ;    and   to 
establish  the  days  within  which  it  is  to  be  expected. 
In  the  book  on  Airs,  Waters,  and  Places,  he  in- 
quires into  the  effects  of  particular  exposures,  of  the 
seasons  and  their  vicissitudes ;  the  influence  of  winds 
and  the  properties  of  waters.     He  alludes  to  the 
diseases  prevalent   in  different  places   and  during 
different  times  of  the  year.     He  contemplates  the 
moral  and  physical  characteristics  of  different  na- 
tions, resulting  from  the  climate,  locality,  and  other 
influences  to  which  they  are  subject.    He  rejects  the 


54:  DISCOURSE. 

superstition  of  his  times  in  reference  to  supernatural 
agencies.  He  holds  that  no  one  disease  is  more  the 
result  of  divine  wrath  than  another,  and  that  all  of 
them  originate  from  natural  causes.  The  predispo- 
sitions resulting  from  the  different  periods  of  life,  he 
studies  with  equal  attention.  He  holds  that  the 
innate  heat  of  the  body  is  at  its  maximum  during 
infancy,  at  its  minimum  in  old  age  ;  and  that  each 
particular  phase  in  this  quality,  like  the  influence  of 
the  sun  in  different  seasons  of  the  year,  predisposes 
to  its  particular  class  of  ailments.  Among  the 
agencies  applying  more  especially  to  the  individual, 
he  dwells  with  becoming  attention  on  diet  and  ex- 
ercise ;  showing  how  excess  or  deficiency  in  the  one 
or  the  other,  may  prove  the  prolific  source  of  dis- 
ease. 

In  connection  with  this  theory  of  innate  heat,  and 
that  of  the  humors,  he  lays  much  stress  on  the 
doctrine  of  Coction  ;  implying  by  this  term,  the 
changes  which  the  disordered  humors  undergo,  pre. 
paratory  to  their  elimination.  So  long  as  they  are 
floating  about  in  a  state  of  crudity,  the  disease  con- 
tinues in  full  intensity  ;  but  w^hen  they  are  properly 
elaborated,  the  disease  reaches  its  crisis,  and  they  are 
discharged,  either  by  the  spontaneous  effort  of  na- 
ture, or  by  the  aid  of  medicine  acting  in  subservi- 
ence to  nature's  laws.  Where  the  crisis  cannot  thus 
be  effected  by  the  removal  of  the  offending  humors 
from  the  body,  it  may  be  brought  about  by  their 
localization  in  particular  organs  or  parts  of  the  body, 
as  by  the  development  of  a  critical  abscess,  by  an 
erysipelatous  inflammation,  by  a  diseased  joint,  or 


DISCOURSE.  55 

by  a  circumscribed  mortification.  But  where  tbe 
crisis  is  not  to  be  effected  either  by  elimination  or 
localization,  the  disease  is  said  to  be  incurable,  as  in 
cancer.  The  critical  discharges,  where  the  disease 
is  general,  may  be  effected  either  by  perspiration^ 
by  the  flow  of  urine,  by  alvine  dejections,  by 
emesis,  or  by  expectoration. 

The  cycle  of  changes  by  which  the  crisis  is 
effected,  he  holds  to  be  usually  completed  within 
certain  definite  periods  of  time;  and  the  days  at 
whifth  the  crisis  may  be  anticipated,  he  calls  Critical 
Days.  He  dwells  with  much  care  on  every  circum- 
stance likely  to  retard  or  accelerate  the  critical 
period,  and  on  the  dangers  to  be  apprehended  dur- 
ing those  critical  days,  regular  or  irregular,  in  which 
the  disease  is  not  adjudicated.  The  study  of  the 
various  appearances  pointing  to  the  probable  result 
of  the  disease,  to  the  character  of  the  crisis,  and  to 
the  time  at  which  this  may  be  expected,  is  summed 
up  in  his  doctrine  of  Prognosis.  By  this  was  meant 
something  more  than  is  implied  in  the  etymology 
of  the  term,  and  much  more  than  is  at  present  un- 
derstood by  it.  In  the  estimation  of  the  early 
Grecians,  Prognosis  was  the  crowning  department  of 
medical  science;  furnishing  them  the  key  for  ex- 
plaining the  past  and  present,  as  well  as  the  yet  to 
be  developed  circumstances  of  disease ;  and  pointing 
out  to  them  what  should  be  left  to  the  efforts  of  na- 
ture, and  what  might  require  the  interference  of  art, 
where  nature,  unassisted,  was  unable  to  bring  the 
disease  to  a  favorable  issue. 

It  is  further  worthy  of  remark,  that  in  the  Hip- 


56  DISCOURSE. 

pocratic  school,  the  condition  and  changes  of  the 
humors,  the  crisis,  the  critical  discharges,  the  critical 
days,  and  above  all,  the  prognostications,  were 
studied  in  the  abstract,  or  as  connected  only  with 
the  condition  of  the  living  body,  without  reference  to 
the  distinctive  traits  of  individual  diseases.  With 
them,  prognosis  was  the  application  of  medical 
science  for  determining  the  value  of  general  mani- 
festations, not  of  particular  morbid  processes.  It 
held  the  same  relation  to  diseases  in  general,  that 
diagnosis,  in  our  use  of  the  term,  now  holds  to 
individual  ailments. 

In  his  book  of  Prognostics,  Hippocrates  dwells 
only  on  the  generalities  of  disease.  In  his  Epi- 
demics he  describes  what  he  himself  had  witnessed, 
even  to  the  progress  and  results  of  individual  cases, 
still  studied  in  the  same  spirit  of  generalization, 
without  reference  to  the  characteristic  features  of 
individual,  much  less  of  specific  diseases.  In  his 
book  on  Regimen  in  Acute  Diseases,  he  appreciates 
his  therapeutics  as  subservient  to  the  indications  of 
nature,  w^hose  efforts  it  becomes  the  physician  to 
assist,  but  never  to  interrupt.  The  teaching  of  Hip- 
pocrates and  his  disciples,  is  thus  shown  to  have 
been  theoretical,  yet  founded  on  what,  at  the  time, 
appeared  to  them  to  be  legitimate  inferences  from 
the  observation  of  facts, — of  facts  carefully  studied 
and  cautiously  generalized.  And  while  the  whole 
science  of  physiology,  and  nearly  the  whole  of  an- 
atomy, remained  yet  to  be  explored,  we  are  not  so 
much  to  be  surprised  at  their  theories,  as  that 
these  theories,  derived  almost  exclusively  from  the 


DISCOURSE.  57 

study  of  external  appearances,  should  have  been  so 
very  near  the  truth. 

As  already  intimated,  several  treatises  in  the  Hip* 
pocratic  collection  must  have  emanated  from  writers 
not  of  the  school  of  Cos,  but  who  are  to  be  con- 
sidered either  among  the  contemporaries  of  Hippo- 
crates, or  of  his  more  immediate  descendants.  The 
book  on  Regimen  for  Persons  in  Health,  has  been 
ascribed  to  Philiston,  who  was  celebrated  for  his 
acquaintance  with  anatomy,  and  who  flourished  about 
the  time  of  Plato.  The  treatise  on  the  Seventh 
Month  Foetus,  has  been  attributed  to  Diodes  of 
Carystus,  also  an  early  writer, — compared,  for 
ability,  with  Hippocrates  himself.  He  was-  the  first 
to  point  to  the  distinction  between  pneumonia  and 
pleurisy  ;  he  was  the  ablest  anatomist  of  his  age, 
and  the  author  of  numerous  works  ;  among  which 
was  a  treatise  on  Hygiene,  and  another  on  Gym- 
nastics as  applied  to  the  treatment  of  disease. 
About  the  same  time  also,  flourished  Petronas,  a  sort 
of  homeopath,  who,  according  to  Celsus,  treated 
fevers  by  overloading  the  sick  with  clothing,  in 
order  to  increase  their  heat  and  thirst.  Praxagoras, 
a  contemporary  of  Aristotle,  appears  to  have  been 
among  the  first  to  allude  to  the  pulse,  a  circum- 
stance, however,  also  mentioned  by  Aristotle  him- 
self, though  not  as  furnishing  any  useful  indications 
in  the  treatment  of  disease.  Plistouicus,  a  pupil  of 
Praxagoras,  may  also  have  contributed  somewhat  to 
the  opinions  promulgated  in  the  Hippocratic  writ- 
ings, particularly  in  reference  to  the  humors;  to  the 
study  of  which  he  and  his  disciples  were  more  than 
5 


58  DISCOURSE. 

usually  attentive.  But  the  portions  of  tlie  collection 
most  at  variance  with  the  doctrines  of  Hippocrates, 
were  probably  derived  from  the  Asclepion  of  Cnidos, 
the  abode  of  many  able  teachers ;  among  the  prin- 
cipal of  whom,  after  Euryphon,  was  Chrysippus. 

Of  the  Cnidian  school,  we  have  no  well-authenti- 
cated remains,  and  no  other  trust- worthy  account 
than  such  as  may  be  found  in  the  few  intimations 
furnished  by  Hippocrates  himself,  and  by  Jiis  com- 
mentator and  disciple,  Galen.  M.  Littre,*  however, 
has  recently  furnished  some  grounds  for  believing 
that  the  second  and  third  book  of  Diseases,  and  the 
book  on  Internal  Affections,  as  at  present  embodied 
in  the  Hippocratic  collection,  are  in  some  respects 
not  in  strict  harmony  with  the  rest ;  and  that  the 
doctrines  contained  in  them,  tested  by  what  is 
known  of  the  Cnidian  Sentences,  prove  to  be  in 
accordance  with  these,  and  consequently,  such  as 
may  have  issued  from  the  Cnidian  school. 

Be  this  as  it  may,  the  doctrines  of  the  two  schools 
were  not  in  every  point  alike.f  And  the  rivalry 
between  their  respective  writers  and  teachers,  dur- 
ing the  early  period  of  scientific  progress,  was  car- 
ried on  with  much  vigor.  Hippocrates,  in  his  book 
on  Ancient  Medicine,  and  again  in  that  on  Regimen 
in  Acute  Diseases,  takes  occasion  to  criticise  the 
opinions  and  practice  of  Euryphon,  as  expressed  in 
the  Sentences.  Ctesias  of  Cnidos,  in  turn,  as  we 
learn  from  Galen,  criticises  the  practice  of  Hippo- 


*  OEuvres  d'Hippocrat,  tome  vii.  p.  304. 

f  Galen  (Kuhn's  edition),  vol.  v.  p.  761 ;  vol.  xv.  p.  363,  42*7. 


DISCOURSE.  59 

crates.  Chrysippus,  of  the  Cnidian  school,  and  his 
disciple  Erasistratus,  oppose  the  use  of  active  pur- 
gatives and  venesection ;  whilst  Herophilus,  at  Alex- 
andria, writes  in  favor  of  the  lancet,  and  is  a 
follower  of  the  Sage  of  Cos. 

The  modes  of  contemplating  disease  in  the  two 
schools,  were  not  alike.  The  Cnidians  attended 
mainly  to  minute  distinctions,  to  the  characteristic 
traits  of  individual  diseases,  with  little  regard  to  the 
bearing  or  mutual  relations  of  special  symptoms. 
Thus  they  enumerated  seven  different  diseases  of  the 
biliary  organs,  twelve  of  the  bladder,  and  four  of 
the  kidneys;  they  described  four  kinds  of  stran- 
gury, three  kinds  of  tetanus,  four  of  jaundice,  and 
three  of  phthisis.  Their  neighbors  of  Cos,  on  the 
other  hand,  held  the  study  of  such  distinctions  to  be 
of  small  account,  and  gave  their  special  attention  to 
the  grouping  of  important  symptoms, — to  what 
would  now  be  called  the  constitutional  condition,  or 
the  state  of  the  system, — without  regard  to  the  par- 
ticular disease,  but  mainly  with  reference  to  the 
prognosis  and  indications  of  treatment. 

In  the  management  of  acute  diseases  the  Cnidians 
employed  numerous  remedies,  and  in  other  affec- 
tions, few.  The  school  of  Cos,  though  at  times  more 
heroic,  especially  in  the  use  of  the  lancet  and  active 
purgatives,  were  in  the  habit  of  managing  acute  dis- 
eases by  a  restricted  regimen ;  barley-water  more  or 
less  diluted,  hydromel,  and  oxymel,  being  among 
their  most  frequent  prescriptions.  In  the  manage- 
ment of  chronic  diseases,  they  favored  the  medical 
gymnastics  of  Herodicus ;  whilst  at  Cnidos  these  dis- 


60  DISCOURSE. 

eases  were  managed  principally  by  laxatives,  and  a 
diet  of  milk,  or  of  milk  and  water.* 

We  might  here  stop  for  a  moment  to  ask,  what 
would  have  been  the  effect  upon  the  progress  of 
medicine  in  ancient  times,  had  these  two  distinct 
modes  of  investigation  been  pursued  with  equal  skill 
and  perseverance  by  both  parties.  For  the  Cnidian 
method  must  have  been  laid  aside  at  an  early  day, 
and  that  of  the  rival  school  universally  adopted. 
Each  method  in  the  abstract,  has  its  respective 
advantages,  and  each  its  own  defects.  In  the  early 
stage  of  inquiry,  while  facts  are  comparatively  few, 
and  insufficient  to  warrant  sound  deductions,  or 
where  their  relative  significance  has  yet  to  be  deter- 
mined, the  Cnidian  method  might  not  only  have 
been  the  safest,  but  the  one  which  would  have  led 
the  most  speedily  and  surely  to  those  results  which 
the  rival  schools  were  ambitious  of  reaching  at  a 
bound.  Hippocrates  and  his  followers,  it  is  true, 
were  not  entirely  indifferent  to  the  study  of  individ- 
ual diseases;  but,  from  their  over-estimate  of  the 
scientific  importance  of  prognostic  indications,  the 
individual  types  of  disease  were  not  so  thoroughly 
investigated  as  they  might  have  been.  Had  they 
dwelt  on  these  with  greater  care,  it  is  possible  that 
most  of  the  diseases  which  are  now  looked  upon  as 
of  comparatively  recent  origin,  and  for  accounts  of 
which  we  search  in  vain  among  the  ancient  medical 
authorities,  might  be  shown  to  have  existed  from 
the   earliest   times.      In    the   progress   of  medical 

*  (Euvres  d'Hippocrate,  par  M.  Littre ;  tome  ii.  p.  198  ;  tome  vii.  p.  304. 


DISCOURSE.  61 

science,  as  in  the  growtli  of  individual  judgment,  tlie 
period  of  observation  must  precede  that  of  philoso- 
phizing. And  until  facts  have  been  accumulated  in 
sufficient  number  and  variety  to  dispel  the  errors 
involved  in  preconceived  opinion,  the  inferences  to 
be  derived  from  them  are,  at  most,  nothing  better 
than  sagacious  speculations.  The  descriptions  of 
epidemic  and  other  diseases,  by  the  early  historians, 
who  drew  from  observation  only,  who  made  no  pre- 
tensions to  medical  knowledge,  and  whose  minds 
were  unembarrassed  by  the  training  of  the  schools, 
are  at  the  present  day  more  worthy  of  reliance  than 
the  accounts  rendered  of  the  same  diseases  by  con- 
temporary medical  authorities.  There  is,  even  in  the 
Hippocratic  code,  nothing  to  compare  in  truthful- 
ness and  fullness  of  detail,  with  the  account  furnished 
by  Thucydides,  of  the  Plague  of  Athens ;  a  disease  ' 
which  prevailed  when  Hippocrates  was  about  thirty 
years  of  age,  and  the  description  of  which  was  prob- 
ably written  before  he  began  his  career  as  an  au- 
thor. This  memorable  passage  from  the  History  of 
the  Peloponnesian  "War,  I  must  here  take  the  lib- 
erty of  condensing. 

"  At  the  beginning  of  the  next  summer,"  says 
Thucydides,*  "  the  Peloponnesians  and  their  allies 
invaded  Attica,  and  laid  waste  the  country.  When 
they  had  not  yet  been  many  days  in  Attica,  the 
plague  began  to  show  itself  among  the  Athenians, 
though  it  was  said  to  have  previously  lighted  on 
many  places  about  Lemnos  and  elsewhere.     Such  a 

*  Book  ii.  chap.  4*7-58. 


62  DISCOURSE. 

pestilence  as  this,  was  nowhere  remembered  to 
have  happened.  The  physicians  were  at  first  of  no 
avail;  treating  it,  as  they  did,  in  ignorance  of  its 
nature.  Nay,  they  themselves  died  most  of  all,  in- 
asmuch as  they  most  visited  the  sick.  Nor  was 
there  relief  in  any  human  art.  As  to  the  suppli- 
cations offered  in  the  temples,  or  the  divinations 
and  other  similar  means,  they  were  all  equally  un- 
availing, and  were  at  length  relinquished  by  the 
people,  who  were  overcome  by  the  pressure  of  the 
calamity. 
\]  "  It  is  said  to  have  first  begun  in  JSthiopia,  then  to 
have  extended  into  Egypt  and  Lybia,  and  the 
greater  part  of  the  king's  territory.  On  the  city  of 
Athens  it  fell  suddenly,  first  attacking  the  men  on 
the  Piraeus,  so  that  it  was  even  supposed  by  them 
that  the  Peloponnesians  had  thrown  poison  into  the 
cisterns ;  for  as  yet  there  were  no  fountains  there. 
It  afterwards  reached  the  upper  city,  where  it  was 
much  more  general.  Now,  let  every  one,  whether 
physician  or  unprofessional  man,  maintain  his  own 
opinion  as  to  the  source  and  causes  of  the  disease ; 
I,  however,  shall  only  describe  its  character,  and  ex- 
plain the  symptoms  by  which  it  may  be  recognized 
should  it  ever  return ;  for  I  was  both  attacked  by 
it  myself,  and  had  personal  observation  of  others 
who  were  suffering  from  it. 

"  That  year,  then,  as  was  generally  allowed,  hap- 
pened to  be  unusually  free  from  other  diseases ;  and 
if  any  such  appeared,  they  all  terminated  in  this. 
Without  any  ostensible  cause,  while  apparently  in 
good  health,  those  about  to  suffer  from  it  were  sud- 


DISCO  U  E  S  E  .  63 

denlj  seized,  at  first,  with  violent  heats  in  the  head, 
redness  and  inflammation  of  the  eyes;  and  imme- 
diately  the   internal   parts,   both   the   throat   and 
tongue,  assumed  a  bloody  tinge,  and  emitted  an  un- 
healthy and  foetid  odor.     Next  came  sneezing  and 
hoarseness,  and  in  a  short  time  the  pain  descended 
to  the  chest,  with  a  violent  cough.     When  it  settled 
on  the  stomach  it  caused  vomiting ;  and  all  the  dis- 
charges of  bile  mentioned  by  physicians,  succeeded, 
and  were  accompanied  with  great  suffering.     An  in- 
effectual retching  also  followed  in  most  cases,  pro- 
ducing  violent   spasms,   which    in   some   instances 
ceased  soon  afterwards,  in  others,  much  later.     Ex- 
ternally, the  body  was  not  very  hot  to  the  touch ; 
nor  was  it  pale,  but  reddish,  livid,  and  broken  out 
in  small  pimples  and  sores.     But  the  internal  parts 
were  burnt  to  such  a  degree  that  the  sick  could 
not   bear    clothing   or    linen  of   the  very  lightest 
kind  to  be  laid  upon  them,  nor  to  be  any  thing  else 
than  stark  naked,  and  would  gladly  have  thrown 
themselves  into  cold  water  if  they  could.     Indeed, 
many  of  those  who  were  not  taken  care  of,  did  so, 
plunging  into  cisterns  in  the  agony  of  unquenchable 
thirst ;  and  it  was  all  the  same  whether  they  drank 
much  or  little.     Moreover,  the  misery  of  restless- 
ness and  wakefulness  continually  oppressed  them. 
The  body  did  not  waste  away  so  long  as  the  disease 
was  at  its  height,  but  resisted  it  beyond  all  expecta- 
tion, so  that  they  either  died  in  most  cases,  on  the 
ninth  or  seventh  day,  through  the  internal  burning, 
while  they  had  still  some  degree  of  strength  ;  or,  if 
they  survived  this  period,  the  disease  descended  into 


64:  DISCOURSE. 

the  bowels,  producing  violent  ulceration  there,  and  in- 
tense diarrhoea,  by  which  the  greater  part  were  car- 
ried off  through  weakness.  For  the  disease,  begin- 
ning in  the  head,  passed  downwards  throughout  the 
whole  body,  and  whoever  survived  its  fatal  conse- 
quences, was  afterwards  affected  in  his  extremities; 
for  it  settled  on  the  pudenda,  fingers,  and  toes,  and 
many  escaped  with  the  loss  of  these ;  others,  also, 
with  loss  of  their  eyes ;  others  again,  were,  on  their 
first  recovery,  seized  with  forgetful n ess,  so  as  not  to 
know  either  themselves  or  their  friends. 

"The  severity  of  the  disease  surpassed  descrip- 
tion, and  in  the  following  way  it  proved  itself  to  be 
different  from  other  diseases.  All  the  birds  and 
beasts  that  prey  on  human  bodies,  did  not  come 
near  these,  though  many  bodies  were  lying  unbur- 
ied ;  or  if  they  did,  they  died  after  they  had 
tasted  them.  As  a  proof  of  this,  there  was  a 
marked  disappearance  of  birds  of  this  kind ;  while 
the  dogs,  from  their  domestic  habits,  afforded  even 
clearer  opportunity  for  marking  the  result  here 
mentioned. 

"  To  pass  over  many  points,  one  case  of  the  dis- 
ease differed  from  another ;  yet,  in  its  general  char- 
acter, it  was  such  as  is  here  described.  Among 
those  attacked,  some  died  in  neglect,  others  in  the 
midst  of  every  attention.  There  was  no  settled 
remedy,  and  what  did  good  to  one,  did  harm  to  an- 
other. No  constitution  was  proof  against  it,  but 
it  seized  on  all  alike,  even  those  that  were  treated 
with  all  possible  regard  to  diet.  The  most  dread- 
ful part  of  the  calamity  was  the  dejection  of  those 


DISCOURSE.  65 

who  found  themselves  sickening,  and  the  fact  of 
their  being  charged  with  the  infection  from  attend- 
ing on  one  another,  and  so  dying  like  sheep ;  for 
when  seized,  they  fell  into  despair,  and  by  abandon- 
ing themselves  the  more  certainly  to  the  disease, 
they  were  the  less  able  to  resist  it.  It  was  this 
that  caused  the  greatest  mortality;  for  if  through 
fear  they  were  unwilling  to  assist  each  other,  they 
perished  from  being  deserted  ;  or  if  they  did  visit, 
they  met  their  death,  especially  such  as  made  any 
pretensions  to  goodness,  or  who,  from  a  feeling  of 
shame,  were  unsparing  of  themselves,  going  into 
their  friends'  houses,  where  even  the  members  of 
the  family  were  worn  out  with  the  moanings  of  the 
dying,  and  overcome  with  excessive  misery.  Still 
more,  however,  than  even  these,  did  such  as  had 
escaped  the  disorder,  show  pity  for  the  dying  and 
the  suffering,  both  from  their  previous  knowledge  of 
what  it  was,  and  from  being  now  in  no  fear  of  it 
themselves ;  for  it  never  seized  the  same  person 
twice,  so  as  to  prove  actually  fatal. 

"  In  addition  to  the  original  calamity,  what  op- 
pressed them  still  more,  was  the  crowding  of  the 
city  with  new  comers  from  the  country.  For,  as 
these  had  no  houses,  and  were  forced  to  live  in  stifl- 
ing cabins  at  the  hot  season  of  the  year,  the  mortal- 
ity amongst  them  spread  without  restraint ;  bodies 
lying  on  one  another  in  the  death-agony,  and  half- 
dead  creatures  rolling  about  in  the  streets,  and 
around  all  the  fountains,  in  their  longing  for  water. 
The  sacred  places  also,  in  which  they  had  quartered, 
were  full  of  the  corpses  of  those  who  died  there ; 
for,  in  the  surpassing  violence  of  the  calamity,  men 


DISCOTJKSE 


came  to  disregard  every  thing,  'botli  sacred  and  pro- 
fane. All  the  laws  of  burial  were  violated,  and 
many  from  want  of  proper  means,  had  recourse  to 
shameless  modes  of  sepulture ;  for,  on  the  piles  pre- 
pared for  others,  some,  anticipating  those  who  had 
raised  them,  would  lay  their  own  dead,  and  set  fire 
to  them  ;  and  others,  while  the  body  of  a  stranger 
was  burning,  would  throw  on  the  top  of  it  the  one 
they  were  carrying,  and  go  away. 

"  In  other  respects  also,  the  plague  was  the  origin 
of  lawless  conduct,  for  the  deeds  which  men  had 
formerly  hidden  from  view,  were  now  openly  per- 
petrated. Seeing  the  sudden  changes,  they  resolved 
to  take  their  enjoyment  quickly;  regarding  their 
lives  and  their  riches  alike  as  things  of  a  day.  As 
for  taking  trouble  about  what  was  thought  honor- 
able, no  one  was  forward  to  do  it,  deeming  it  uncer- 
tain whether  before  he  had  attained  it,  he  would 
not  be  cut  off.  And  as  to  fear  of  gods,  or  law  of 
men — there  was  none  to  stop  them. 

^'  Such  was  the  calamity  which  afflicted  the  Athe- 
nians, their  men  dying  within  the  city,  and  their 
lands  being  wasted  without.  Their  fleet  too,  which, 
during  the  same  summer,  had  proceeded  against 
Potidsea,  was  unsuccessful ;  the  plague  attacking  the 
forces,  and  utterly  overpowering  them,  so  that  out 
of  four  thousand  heavy-armed  men,  fifteen  hundred 
perished  in  about  forty  days ;  and  the  soldiers  of 
the  Athenians,  who  had  been  there  before  the  ar- 
rival of  the  fleet,  became  infected  by  the  newly 
arrived  t  roops,  though  previously  they  had  been  in 
good  health. 

"•  On  the  following  winter,"  adds  Thucydides  in 


DISCOURSE.  67 

another  place,*  "  the  plague  a  second  time  attacked 
the  Athenians,  having,  indeed,  never  entirely  left 
them,  though  there  had  been  some  abatement  of  it. 
It  lasted,  the  second  time,  not  less  than  a  year,  the 
former  attack  having  lasted  two ;  so  that  nothing 
reduced  the  power  of  the  Athenians  more  than  this, 
for  not  less  than  four  thousand  four  hundred  heavy- 
armed  in  the  ranks,  died  of  it ;  and  three  hundred 
of  the  equestrian  order,  with  a  number  of  the  multi- 
tude that  was  never  ascertained.  It  was  at  this 
time  also,  that  the  numerous  earthquakes  happened 
at  Athens,  Eubsea,  and  Boeotia,  particularly  at  Or- 
chomenos  in  the  last-named  country." 

One  circumstance  mentioned  in  the  foregoing  pas- 
sages from  Thucydides,  is  worthy  of  particular  no- 
tice, his  direct  allusion  to  the  spread  of  this  disease 
by  infection,  a  subject  rarely  if  ever  referred  to  by 
the  medical  authorities  of  antiquity,  and  upon  which 
I  shall  again  have  occasion  to  speak  in  connection 
with  Pliny's  account  of  the  Mentagra  of  the 
Romans. 

Before  closing  our  notice  of  medicine  among  the 
early  Grecians,  having  already  ventured  beyood  the 
strictly  professional  authorities,  it  is  but  proper  to 
give  some  attention  to  an  author  whose  writings, 
more  than  those  of  most  other  men,  have  been  in- 
strumental in  exciting  to  discussion  and  inquiry  in 
every  branch  of  science.  I  allude  to  Aristotle.  I 
need  not  in  this  connection  refer  to  his  influence  as 
a  teacher  of  philosophy.     In   this  department  he 


III.  SI, 


68  DISCOUESE. 

divided  with  Plato  tlie  admiration  of  the  ancient 
world,  and  throughout  the  middle  ages  was  held  in 
supreme  authority  among  the  schoolmen.  I  refer 
to  him  here  simply  as  a  contributor  to  our  know- 
ledge of  animated  nature,  to  anatomy,  and  physi- 
ology, to  the  history  of  the  lower  animals,  and  of 
many  of  their  diseases. 

The  work  of  Aristotle,  entitled  "  De  Animalibus 
Historige,"*  is  divided  into  nine  books.  In  book 
first  he  gives  the  configuration  of  every  organ  and 
part  of  the  human  body,  accessible  to  the  sight 
without  the  aid  of  dissection ;  next,  acknowledging 
his  utter  ignorance  of  the  internal  structure  of  the 
body,  he  proceeds  to  describe  that  of  such  lower 
animals  as  are  thought  to  bear  the  greatest  resem- 
blance to  the  human  race.  In  book  second  he  gives 
the  organization  of  the  various  classes  of  animals 
supplied  with  blood,  meaning  such  as  have  red 
blood.  In  book  third  he  gives  a  treatise  on  what 
would  now  be  called  general  anatomy,  or  the 
anatomy  of  the  simple  tissues  and  structures :  the 
blood-vessels,  and  the  heart ;  the  nervous,  and  what 
we  would  call  the  tendinous,  and  some  of  the  mem- 
branous tissues  and  organs;  the  firmer  fibrous 
tissues  ;  the  bones,  the  cartilages,  the  tegumentary 
envelopes  and  their  modifications  in  diff'erent  classes 
of  animals  ;  the  substance  of  the  brain  and  its  en- 
velopes ;  the  envelopes  of  the  bones ;  the  muscular 
tissue ;  the  fat ;  the  blood ;  the  medulla  of  bones ;  the 


*  Aristotelis  de  Animalibus  Historise  libri  x,     Lipsise,  1811,  4  vols.  8vo. 
of  which  the  last  book  is  spurious. 


DISCOUESE.  69 

milk,  and  seminal  fluid.  In  book  fourtk  be  pro- 
ceeds to  describe  with  equal  care  the  organization, 
of  the  different  classes  of  animals  without  blood,  or 
as  we  would  say,  having  only  white  blood.  Books 
fifth  and  sixth  treat  of  the  reproductive  functions  of 
the  lower  animals,  from  the  simplest  upwards  ;  book 
seventh,  of  the  corresponding  functions  in  the  hu- 
man race  ;  and  the  two  remaining  books,  of  the 
habits,  localities,  instincts,  and  propensities  of  the 
lower  animals ;  several  chapters  of  the  eighth 
book  being  devoted  to  their  diseases. 

His  division  of  the  parts  of  animals  into  simple 
and  compound,  was  adopted  by  most  of  the  later 
writers  on  anatomy,  and  particalady  by  Galen.  He 
denies  the  assumption  of  Alcmaeon,  that  goats  are 
able  to  respire  through  their  ears.  He  describes 
the  two  envelopes  of  the  brain ;  the  firmer  invest- 
ing the  inner  surface  of  the  skull ;  the  more  deli- 
cate or  venous  membrane  resembling  a  skin,  sur- 
rounding the  brain  itself;  which,  he  says,  is  with- 
out blood,  and  consists  of  two  parts,  the  cerebrum 
and  cerebellum.  He  alludes  also  to  the  lateral 
ventricles.  He  gives  a  sufficiently  close  and  ac- 
curate description  of  the  respiratory  organs,  and 
their  connection  with  the  heart.  It  is  not  certain, 
says  he,  when  air  has  traversed  the  arteria  aspera 
whether  it  passes  directly  to  the  heart  by  the  lungs, 
in  all  animals;  though  he  held  such  to  be  the  fact 
in  most  of  them.  Of  all  the  organs  the  heart  alone 
holds  blood  within  itself;  for  the  blood  of  the 
lungs  is  not  proper  to  them,  but  is  contained  with- 
in the   vessels   in  communication   with   the   heart. 


TO  DISCOURSE. 

The  blood  in  the  middle  sinus  of  the  heart  is  the 
most  attenuated. 

He  refers  to  the  erroneous  opinions  of  earlier  writ- 
ers, particularly  to  those  of  Syennesis  of  Cyprus, 
Diogenes  Apolloniata,  and  Polybius,  in  regard  to  the 
origin  and  distribution  of  the  blood-vessels;  and 
after  alluding  to  the  difficulty  of  the  investigation, 
proceeds  to  give  his  own  account  of  them.  These 
vessels,  he  declares,  have  not  their  origin  in  the 
head  or  brain ;  but  are  derived  directly  from  the 
heart.  Here  the  nerves  also  receive  their  origin. 
There  are,  he  adds,  two  veins  within  the  chest  near 
the  spine,  the  larger  of  which  lies  in  front  of  the 
other,  and  more  towards  the  right  side.  The  smaller 
of  the  two  is  of  a  nervous  structure  when  seen  in 
the  dead  subject,  and  is  called  the  aorta.  Both  of 
these  vessels  have  their  origin  in  the  heart;  through 
whatever  viscera  they  pass,  their  course  is  continu- 
ous and  uninterrupted.  The  heart  constitutes,  as  it 
were,  a  part  of  them;  particularly  its  anterior  por- 
tion, where  it  is  connected  with  veins  passing  both 
upwards  and  downwards  ;  the  heart  itself  resting  in 
the  midst.  He  attempts  to  show  a  connection  be- 
tween the  branches  of  the  vena-magna  after  pass- 
ing through  the  diaphragm  to  the  liver,  with  other 
veins  passing  upward  towards  the  right  axilla  and 
arm  ;  adding  that  the  physicians,  by  drawing  blood 
from  the  vessels  of  this  arm,  are  enabled  to  cure 
certain  diseases  of  the  liver.  A  similar  connection 
he  elsewhere  traces  between  the  vessels  of  the 
spleen  and  those  of  the  left  arm. 

The  blood  is  thicker  and  darker  in  the  lower, 


Dl&C0rR9E,  71 

than  in  tlie  upper  parts  of  the  body.  In  the  veins 
of  all  animals  it  is  observed  to  palpitate.  It  is  the 
only  one  of  all  the  humors  which  is  always  present 
so  long  as  life  endures.  It  is  supplied  from  the 
blandest  fluids  of  the  body,  and  formed  within  the 
heart.  Deprived  of  it  to  a  slight  degree,  the  animal 
faints;  to  a  greater  extent,  the  animal  dies.  It 
changes  in  quality  with  the  periods  of  life ;  and  if 
too  thin,"  it  leads  to  diseases.  When  vitiated  it 
gives  rise  to  hsemq^rhoidal  flux,  to  epistaxis,  to  pileSy 
and  to  varices.  Pus  is  the  result  of  its  putrefaction. 
The  bones,  deprived  of  their  fibrous  envelope,  desic- 
cate ;  the  bladder  and  other  membranous  or  ner- 
vous sacks  and  tissues,  when  cut,  never  heal. 

Among  quadrupeds  the  hog  is  subject  to  three 
diseases,  all  of  which  he  describes,  giving  the  symp- 
toms and  mode  of  treatment,  namely,  —  angina, 
which  extends  from  the  throat  to  the  luno^s  and 
other  parts  of  the  body ;  scrofula,  affecting  the  head 
and  contiguous  parts ;  and  a  disease  of  the  bowels, 
which  is  usually  fatal.  Dogs  are  also  subject  to 
three  diseases, — rabies,,  angina,  and  podagra ;  all  of 
which  are  briefly  described.  Rabies  renders  the 
animal  insane,  and  all  others  that  are  bitten  by 
him,  excepting  man;  and  is  fatal  to  all  that  are 
affected  with  it.  And  thus  he  treats  on  the  diseases 
of  other  animals,  savage  and  domestic. 

From  the  foregoing  exposition  it  will  be  seen  that 
in  his  acquaintance  with  anatomy,  physiology,  and, 
we  may  also  add,  general  pathology,  Aristotle  was 
far  in  advance  of  his  epoch,  approaching  more 
closely  to  the  medical  science  of  modern  times  than 


72  DISCOURSE. 

to  the  humoralism  of  antiquity.  With  him  the 
blood  was  the  pabulum  vitse,  which,  when  dis- 
ordered, gave  rise  to  disease  throughout  the  body. 
He  has  nothing  to  say  either  of  the  four  elements, 
or  of  the  four  primitive  humors ;  and  in  his  study  of 
minute  distinctions, — the  characteris#c  trait  of  his 
writings  on  natural  history  as  well  as  on  every 
Dther  branch  of  knowledge, — his  doctrines  were  less 
in  conformity  with  those  of  Hippocrates,  than  with 
those  of  the  school  of  Cnidos. 

The  spirit  of  medical  inquiry,  as  now  shown,  had 
already  far  outgrown  the  confines  of  the  temples. 
Yet,  as  institutions  of  religion,  most  of  these  still 
maintained  their  ancient  ceremonies.  The  Ascle- 
pion  of  Cnidos  is  known  to  have  continued  up  to  the 
age  of  Constantine  ;  when,  in  common  with  other 
remaining  abodes  of  pagan  worship,  by  an  edict  of 
this  emperor,  it  was  leveled  to  the  ground.  But 
the  Asclepiadse  of  Cos,  forgetting  the  influence  of 
their  former  mysteries,  were  preparing  the  way  for 
a  new  order  of  institutions.  By  slow  degrees  they 
lost  the  suffrages  of  the  multitude.  Their  sacred 
groves  and  fountains,  no  longer  the  resort  of  a  con- 
fiding people,  lay  neglected  and  forsaken,  by  priests 
as  well  as  patients ;  and  at  length  the  Roman  Pre- 
fect, Turullius,  in  the  days  of  Mark  Anthony,  while 
at  Cos,  regardless  of  the  divinity  that  once  had 
ruled  within  the  precincts  of  its  hallowed  shades, 
ordered  the  groves  to  be  destroyed,  and  the  timber 
to  be  converted  to  the  uses  of  the   navy."^     ^^Ac 

*  Littre,  loco  citat.  p.  11,  from  Lactantiue.     Schulze,  p.  130. 


DISCOUESE.  Y3 

minus  credunt^  quoe  ad  mlutem  suam  pertinent^  si 
intelligunt!^ 

But,  notwitlistauding  the  waning  of  tlie  Ascle- 
piadse,  tlie  teaching  of  medicine  continued  to 
flourish.  As  early  as  the  time  of  Aristotle,  the 
profession  had  not  only  lost  much  of  its  ancient 
association  with  the  priesthood,  but  had  already  be- 
come divided  into  classes, — the  apothecaries,  whose 
only  business  consisted  in  preparing  and  dispensing 
medicines ;  the  physicians,  engaged  in  general  prac- 
tice ;  and  the  medical  philosophers,  who  pursued 
the  study  as  a  liberal  science  only,  without  devot- 
ing their  attention  to  it  as  an  industrial  occupa- 
tion.f  From  this  latter  class  were  probably  drawn 
the  first  teachers  of  the  Alexandrian  school;  the 
opening  of  which,  about  three-fourths  of  a  century 
after  the  death  of  Hippocrates,  marks  the  second 
great  epoch  in  the  progress  of  medical  knowledge. 


*  Pliny,  Hist.  Nat,  lib.  xxix.  e.  viii. 

t  Aristotle,  Politics,  book  iii.  c.  xi.  and  book  iii,  c.  xvi.  Aristotle  him- 
self, if  we  may  believe  Athenseus  (Deipnosophists,  book  viii.  c.  50),  was  in 
early  life,  after  wasting  his  patrimony,  the  keeper  of  an  apothecary  shop  in 
Athens. 

6 


74:  DI8C0UKSE 


CHAPTEE   V. 

PERGAMUS    AND    ALEXANDRIA. 

The  rapid  extension  of  Grecian  arms  under  Alex- 
ander the  Great,  led  to  the  diffusion  of  taste  and 
learning  among  the  surrounding  nations.  Perga- 
mus  and  the  new  capital  of  Egypt,  became  points 
of  scientific  attraction  second  only  to  Athens;  and 
with  the  spread  of  general  knowledge,  the  study  of 
medicine  extended  to  these  cities. 

At  Pergamus,  a  library  of  immense  extent  had 
been  accumulated  by  the  predecessors  of  the  first 
Attains.*  The  Asclepion  of  this  city  was  among 
the  earliest  off-shoots  from  that  of  Epidaurus.f  The . 
peristyle  of  the  temple,  and  the  avenues  leading  to 
it,  were  occupied  as  places  of  public  instruction  and 
scientific  intercourse.  Here  the  orators,  sophists, 
and  philosophers  of  the  city,  held  their  daily  con- 
ferences, and  sometimes  amused  themselves  in  ex- 
pounding to  the  sick  the  vaticinations  of  the  priests. 
As  a  school  of  medicine,  the  Asclepion  of  Pergamus 
enjoyed  a  long-continued  celebrity  ;  but  its  bright- 
est era  was  after  the  first  decadence  of  the  Alexan- 
drian school. 

The  city  of  Alexandria,  from  which  issued  much 

*  Vitruvius,  lib.  vii.,  prgefatio,  §  4. 

t  Le  Clerc,  lib.  i.  chap,  xx.,  after  Pausaniaa. 


DISCOURSE.  75 

of  the  later  learning  of  antiquity,  was  projected  by 
the  architect,  Dinocrate?,^  commenced  during  the 
lifetime  of  Alexander,  and  carried  nearly  to  com- 
pletion by  Ptolemy  Soter ;  but  many  of  its  public 
works  remained  to  be  finished  under  his  son  and 
successor,  Philadelphus.f     By  means  of  an  artificial 
causeway,  jutting  three-fourths  of  a  mile  into  the 
sea,  the  long  and  narrow  island  called  Pharos,  in 
front  of  the  city,  was  connected  to  the  main  land,  and 
thus  converted  into  a  breakwater  for  the  protection 
of  the  spacious  harbor ;   in  front  of  which  stood 
most  of  the  public  edifices.   From  the  temple  of  Pan, 
which  rose  like  a  sugar-loaf  in  the  center,  the  whole 
of  this  remarkable  capital  could  be  surveyed  at  a 
glance.       Its   two   main   streets   crossing   at   right 
angles,  were  flanked  with  rows  of  columns  ;  the  one 
extended  lengthwise  thirty  stadia,  or  about  three 
miles;  and  the  other  transversly  about  one-fourth 
of  this  distance.     Fronting  the  harbor  in  the  middle 
of  the  principal  avenue,  stood  the  Soma,  or  mauso- 
leum of  the  Greek  kings,  taking  its  name  from  the 
body,  meaning  the  body  of  Alexander,  which  was 
the  first  therein   deposited.     Ranging  in  a  line  with 
this  along  the  shore,  stood  the  temple  of  Neptune, 
the   Emporium  or  Exchange,  the  royal  docks,  the 
hall  of  justice,  the  Serapium,  and  the  Museum  of 
College  of  Philosophy.     Beyond  the  Heptastadion, 
as  the  stone  causeway,  from  its  length,  was  called, 
were  seen  other  docks;  and  beyond  the  walls,  the 
theater,  the  amphitheater,  and  the  beautiful  Gymna- 

*  Vitruvius,  lib.  ii.,  prsefat.  §  4. 
f  See  Sharpe's  Egypt,  pasbim. 


T6  DISCOURSE. 

sium  for  athletic  exercises,  with  its  stoa  or  portico 
of  a  stadium  in  length,  where  the  pentennial  games 
were  celebrated.  On  one  side  of  the  city  could  be 
seen  the  Hippodrome  for  chariot  races,  on  the  other, 
the  public  groves  and  gardens  ;  still  further  off,  the 
Necropolis,  with  its  tombs  and  sepulchral  monu- 
ments ornamenting  the  roadside  for  miles  along  the 
shore ;  and  beyond  the  western  wall,  the  ship-canal 
connecting  the  harbor  of  Eunostus  with  lake  Mare- 
otis,  which  lay  beyond  the  suburbs ;  and  to  which,^ 
when  the  city  contained  its  three  hundred  thousand-" 
souls,  these  suburbs  reached. 

The  Serapium,  or  temple  of  Serapis,  on  the  prom- 
ontory of  Lochias,  at  the  western  extremity  of  the 
great  harbor,  was  an  object  as  striking  to  the  obser- 
ver as  the  lighthouse  at  the  other.     Standing  within 
the  western  gate,  this  temple,  the  most  magnificent 
of  all  the  buildings,  was  approached  on  one  side  by 
a  slope  for  carriages ;  on  the  other,  by  a  flight  of  a 
hundred  steps,  widening  as  they  ascended  from  the 
street.     At  the  top  of  these  was  the  portico,  with 
its  circular  roof  and  its  supporting  columns,  which 
gave  entrance  to  the  great  court-yard ;  in  the  middle 
of  which  stood  the  roofless  hall  of  the  temple,  encir- 
cled with  columns  and  porticos  inside  and  out.     En- 
closed within  these  porticos  were  chambers  dedicated 
to  the  rites  of  the  ancient  religion  of  the  country. 
In  one  of  these  stood,  glittering  with  gold  and  sil- 
ver, the  colossal  statue  of  Serapis,  the  god  whose 
worship  became  so  popular  irf  the  latter  ages  of  the 
Koman  empire  ;  and,  as  if  to  impress  the  multitude 
with  superstitious  awe,  the  light  here  was  so  ar- 


DISC0I7ESE.  77 

ranged  as  to  allow  the  sun's  rays,  at  appointed  times, 
to  illuminate  the  statue's  lips.  But  among  the 
inner  porticos  at  a  later  period,  were  deposited  por- 
tions of  that  library  which  rendered  Alexandria  the 
great  repository  of  the  science  and  wisdom  of  the 
ancients.  In  the  middle  of  the  inner  area  of  the 
temple  stood  a  lofty  column,  visible  from  all  the 
country  round,  and  from  ships  far  off  at  sea.  And 
when  the  temple  itself,  with  its  fountain,  its  two 
obelisks,  its  gilded  roofs,  its  painted  chambers  and 
glittering  architectural  ornaments,  had  perished, 
this  column,  under  the  name  of  Pompey's  Pillar,  still 
stood,  to  vie,  in  magnitude  and  durability,  with  the 
yet  remaining  monuments  of  the  earlier  Egyptians. 

But,  among  the  public  buildings  of  the  rising 
capital,  that  which  has  the  greatest  claim  upon  our 
attention,  and  to  which  the  city  ultimately  owed  its 
fairest  fame,  was  the  Museum.  This  stood  in  the 
quarter  of  the  Bruchium,  fronting  the  harbor.  Its 
chief  apartment  was  a  great  hall,  which  served  as  a 
lecture-room  and  place  of  general  concourse.  Around 
the  main  building,  on  the  outside,  was  a  covered 
walk  or  portico ;  and  connected  with  it,  was  an  Ex- 
hedra,  in  which  the  philosophers  sometimes  sat  in 
the  open  air. 

This  noble  institution  was  originally  designed  to 
serve  in  part  as  a  school  for  the  training  of  youth 
in  the  higher  walks  of  learning,  and  in  part  as  a 
retreat  within  which  men  of  genius  and  acquire- 
ments, free  from  the  necessity  of  providing  for  their 
daily  wants,  might  have  leisure  and  opportunity, 
each  in  his  own  way,  for  extending  the  domain  of 


78 


DISCOURSE 


science,  or  for  increasing  the  enjoyments  or  im- 
proving the  condition  of  their  fellow-beings.  It  may 
have  owed  its  origin,  as  it  owed  much  of  its  early 
celebrity,  to  the  intimate  relation  existing  between 
the  family  and  descendants  of  Aristotle,  and  those 
of  Alexander  the  Grreat*  For,  Nicomachus,  the 
father  of  the  philosopher,  was  the  physician  and 
friend  of  Amyntas,  the  grandfather  of  the  con- 
queror ;  and  Alexander  himself  had  been  the  pupil 
and  afterwards  the  patron  of  Aristotle.  Again, 
Erasistratus,  the  grandson  of  the  latter,  was  among 
the  most  prominent  of  the  scientific  men  brought 
together  at  the  Museum  by  Ptolemy  Soter,  its 
founder;  who  was,  by  repute,  the  natural  son  of 
of  Philip,  and  consequently,  brother  to  Alexander. 
And  finally,  we  read  of  another  Nicomachus,  a. 
name  for  several  generations  running  through  the 
family  of  Aristotle,  among  the  associates  of  the 
Museum  at  a  later  date. 

The  men  of  learning  in  the  several  faculties  of 
this  institution,  lived  together  in  a  sort  of  frater- 
nity, eating  at  a  common  table,  supported  in  whole 
or  in  part  at  the  public  expense.  Some  of  them 
officiated  as  professors  under  a  fixed  salary ;  some 
of  them  as  private  tutors,  deriving  at  least  a  portion 
of  their  income  from  their  pupils  ;  some  of  them 
were  engaged  in  the  public  works,  or  in  the  ser- 
vice of  the  state ;  and  some,  as  original  investigators 

*  We  are  told  by  Strabo,  that  Aristotle  was  the  first  to  collect  a 
library;  and  that  the  kings  of  Egypt,  after  his  example,  founded  the 
library  of  the  Museum.  See  Schulze,  p.  359.  Athenseus,  however,  as  we 
shall  see,  mentions  earlier  collections. 


DISCOURSE.  79 

in  the  arts,  in  literature  or  philosophy,  or  in  works 
of  fancy,  in  the  exact  sciences,  in  natural  history,  or 
in  medicine. 

Under  Ptolemy  Philadelphus,  the  Museum  had 
already  risen  to  the  highest  rank  among  the  Greek 
schools.  Its  library  already  held  two  hundred 
thousand  rolls  of  papyrus,  equal  to  about  ten  thou- 
sand of  our  modern  printed  volumes.  At  the  head 
of  this  library,  under  Ptolemy  Soter,  its  founder, 
was  Demetrius  Phalereus,  who  had  formerly  been 
chief-magistrate  of  Athens.  The  system  of  instruc- 
tion, as  at  first  arranged,  was  divided  among  the 
four  faculties  of  literature,  mathematics,  astronomy  , 
and  medicine ;  but  other  faculties,  or  special  depart- 
ments, must  have  been  early  adjoined  to  these. 

At  the  head  of  the  mathematical  department  was 
Euclid.  In  that  of  poetry  were  Theocritus  and 
Callimachus.  The  chair  of  philosophy  was  assigned 
to  Hegesias  of  Gyrene,  that  of  astronomy  to  Timo- 
charis.  The  department  of  natural  history  was 
under  Philostephanus,  then  engaged  in  a  work  on 
the  history  of  fishes.  Manetho,  an  aboriginal 
Egyptian,  was  occupied  in  preparing  an  elaborate 
history  of  his  own  country;  and  Timosthenes,  the 
commander  of  the  fleet,  had  in  charge  the  subject  of 
geography.  In  the  medical  faculty  were  Gleom- 
brotus  of  Gos,  Herophilus,  and  Erasistratus.  The 
first  of  these  was  in  high  repute  as  a  practitioner ; 
was  sent  to  the  relief  of  Antiochus  when  danger- 
ously ill,  and  after  curing  that  king,  received  on  his 
return  a  present  of  a  hundred  talents,  about  fifteen 
thousand  pounds  sterling,  as  a  reward  from  Phila- 
delphus. 


80  DISCOURSE. 

Ptolemy  Sober  was  himself  an  author,  and  the 
biographer  of  Alexander.  As  a  man  of  enlightened 
understanding  and  cultivated  taste,  he  took  delight 
in  the  society  of  the  Museum.  He  was  in  daily 
intercourse  with  the  philosophers,  listening  to  their 
discourses  in  the  lecture-room,  or  entertaining  them 
at  his  own  table.  At  one  of  these  literary  dinners 
he  is  said  to  have  asked  Euclid  for  a  shorter  way  to 
the  higher  mathematics  than  that  by  which  the 
pupils  were  led  in  the  lecture-room ;  when  Euclid, 
as  if  to  remind  him  of  the  royal  roads  of  Persia 
which  ran  by  the  side  of  the  public  highways,  but 
were  kept  clear  and  free  for  the  king's  use, — gave 
him  the  well-known  reply,  that  there  is  no  royal 
road  to  geometry. 

Among  the  rhetoricians  of  the  museum  was  the 
sophist  Diodotus  Cronus,  with  whom  Ptolemy  was 
in  the  habit  of  jesting,  and  who  among  other  para- 
doxes maintained  the  non-existence  of  motion, — 
arguing  that  motion  was  neither  in  the  place  from 
which  bodies  moved,  nor  in  that  to  which  bodies 
moved,  and  consequently  had  no  existence.  Cronus, 
however,  by  a  fall,  dislocated  his  shoulder;  and 
when  asked  by  Herophilus,  who  had  been  called  to 
assist  him,  whether  the  fall  had  occurred  at  the 
place  where  the  shoulder  now  was,  or  at  that  from 
which  it  had  descended,  he  was  by  no  means  con- 
tented with  the  application  of  his  own  argument, 
and  begged  the  physician  to  begin  at  once  by  adjust- 
ing the  dislocation. 

The  seven  ablest  literary  men  at  the  Museum, 
were  called  the  Pleiades ;  and  they  had  in  charge 


DISCOUBSE.  81 

the  business  of  adjudging  prizes  and  rewards  to  tlie 
pupils.  At  one  of  their  public  sessions,  a  chair 
accidentally  vacant  among  them,  was,  for  the  mo- 
ment, assigned  to  the  grammarian  Aristophanes. 
When  the  reading  of  the  exercises  was  ended,  and 
most  of  those  present  were  agreed  upon  the  one 
deemed  best  of  all  the  compositions,  Aristoph- 
anes dissented  from  the  general  judgment,  and 
pointed  to  the  very  volume  in  the  library  from 
which  this  performance  had  been  copied.  Ptolemy 
was  struck  with  this  test  of  the  grammarian's 
acquirements,  and  soon  afterwards  promoted  him  to 
the  post  of  librarian,  then  the  most  honorable 
office  of  the  Museum.  The  Ptolmies  reserved  to 
themselves  the  right  of  appointment  to  office,  and 
occasionally  silenced  the  professors.  Hegesias,  in 
the  midst  of  a  discourse  against  the  fear  of  death, 
was  thus  silenced,  lest  by  his  eloquence  he  might 
excite  a  passion  for  suicide  among  his  hearers.  But, 
while  watching  with  solicitude  over  the  business  of 
oral  instruction,  they  took  no  official  notice  of  books. 
And  Hegesias,  no  longer  able  to  lecture,  consoled 
himself  by  recording  his  opinions,  and  circulating 
them  among  his  friends. 

At  a  time  when  books  were  expensive  and  readers 
few,  the  influence  of  private  reading  could  hardly 
be  felt  upon  the  social  institutions  or  political  des- 
tiny of  the  nation ;  and  hence  it  was  disregarded. 
Not  so  with  oral  instruction.  Among  the  Greeks 
this  had  always  been  the  common  mode  of  enlight- 
ening the  people,  of  amusing  them,  and  of  molding 
their  opinions.     Most  of  the  poetry,  and  much  of 


82  DISCOURSE. 

the  written  history  of  the  nation,  were  prepared  for 
public  recitation.  Plato,*  aware  of  the  influence  of 
such  exercises,  would  have  had  a  censorship  upon 
the  poets,  that  they  might  not  be  permitted  to  recite 
their  compositions  in  public  before  submitting  them 
to  the  judges  and  guardians  of  the  law,  and  obtaining 
their  approbation.  The  business  of  lecturing,  there- 
fore, was  at  Alexandria,  as  in  the  other  cities,  of  more 
importance  than  that  of  composing  for  the  private 
reader.  The  custom  of  appointing  readers  for 
familiarizing  the  people  with  Homer  and  other  stan- 
dard authors,  had  already  been  introduced  here. 
And  Hegesias,  after  the  loss  of  his  professorial 
chair,  was  occupied  as  the  official  reader  of  Herod- 
otus. 

Before  the  settlement  of  Egypt  by  the  Greeks, 
papyrus  was  only  in  limited  use  among  them.  Their 
adoption  of  this  material  in  the  making  of  books, 
was  an  improvement  almost  equal  to  the  modern 
invention  of  printing.  To  many  of  the  people 
books  were  now  known  for  the  first  time ;  and  the 
new  substance  upon  which  they  were  written,  re- 
placing the  wax  tablets,  the  rolls  of  bark,  the  cloth, 
and  other  articles  formerly  employed,  continued  in 
general  use  until  it  was  in  turn  superseded  by  the 
comparatively  recent  invention  of  writing  paper. 
The  Charta  Pergamenta,  or  parchment,  introduced 
two  hundred  years  later  than  papyrus,  was  always  too 
expensive  for  general  use,  and  was,  indeed,  an  inven- 
tion of  necessity  by  the  scholars  of  Pergamus,  when 

*  In  the  Laws,  book  vii.  c  9. 


DISCOURSE.  83 

Ptolemy  Euergetes  Jealous  of  tlie  rising  reputation  of 
the  great  library  of  that  city,  undertook  to  arrest  its 
increase  by  prohibiting  the  export  of  papyrus  from 
Egypt.  Thus,  two  of  our  own  words, — parchment 
from  Pergamus,  and  paper  from  papyrus, — stand  as 
monuments  of  the  rivalry  in  the  collecting  of  books, 
which  once  existed  between  Eumenes  of  Pergamus, 
and  Euergetes  of  Egypt. 

This  rivalry  continued  until  the  kingdom  of  Per- 
gamus was  bequeathed  to  the  Eomans.  And  not 
long  after  this  event,  when  Julius  Caesar  set  fire  to 
his  own  fleet  in  the  harbor  of  Alexandria,  the  flames 
accidentally  extending  to  the  Museum,  which  stood 
in  the  immediate  vicinity  of  the  docks,  the  building 
was  consumed ;  and  with  it  perished  in  the  flames 
that  library  which  had  been  the  growth  of  ages, 
and  which,  at  this  time,  contained  not  fewer  than 
YOOjOOO  volumes.  The  Museum  was  soon  after- 
wards rebuilt.  And  to  supply,  as  far  as  possible, 
the  loss  of  the  library,  Mark  Anthony,  when  in 
power,  presented  to  Cleopatra  the  200,000  volumes 
which  had  hitherto  been  the  greatest  boast  of  Per- 
gamus. This  literary  treasure  was  afterwards  de- 
posited in  the  Serapium,  and  Alexandria  once  more 
contained  the  largest  library  in  the  world. 

In  connection  with  the  libraries  of  Alexandria 
and  Pergamus,  it  may  be  here  observed  that  among 
the  celebrated  collections  of  earlier  date,  were 
those  of  Polycrates,  king  of  Samos  ;  of  Pisistratus, 
the  tyrant  of  Athens ;  of  Euclides,  the  Athenian ; 
of  Nicorrates,  the  Samian ;  and  of  Aristotle  and  his 
librarian,  Nelius..    This  latter  collection,  or  at  least 


84:  DISCOURSE. 

the  greater  part  of  it,  was  purchased  by  Ptolemy 
Philadelphus,  and,  with  other  collections  from 
Ehodes,  constituted  the  nucleus  of  the  first  library 
of  Alexandria.* 


CHAPTER   VI. 

THE   SCHOOL   OF   MEDICINE    AT   ALEXAKDEIA. 

Among  the  earliest  members  of  the  Museum  who 
devoted  their  attention  to  medicine,  by  far  the  most 
conspicuous  were  Herophilus  and  Erasistratus. 

Herophilus  was  a  native  of  Chalcedon,  and  pupil 
of  Praxagoras  of  Cos.f  He  was  an  original  investi- 
gator ;  and,  after  Diodes  of  Carytus,  the  first  of  the 
Hippocratic  school  to  distinguish  himself  as  an  an- 
atomist. To  him  we  owe  many  of  the  anatomical 
terms  still  in  use.  He  was  the  first  to  direct  atten- 
tion to  the  pulse  as  an  index  of  the  varying  condi- 
tions of  health  and  disease ;  properly  attributing 
the  pulsation  of  the  arteries  to  the  action  of  the 
heart.  He  was  familiar  with  the  course  of  the  lac- 
teal vessels,  and  with  their  relation  to  the  mesenteric 
glands.  He  experimented  on  living  animals,  and 
even  on  condemned  criminals  placed  at  his  disposal 
in  the  prisons.     He  dissected  human  bodies.     His 

*  Athenseus. — ^The  Deipnosophists,  book  i.  chapter  iv. 
f  See  Galen,  in  numerous  places ;  also  Celsus,  in  his  preface  and  else- 
where. 


DISCOTJRSE.  85 

physiological  researches  excited  the  indignation  of 
the  populace  to  such  an  extent  as  to  require  the 
strong  arm  of  arbitrary  power  for  his  protection. 
He  traced  most  diseases  to  the  humors.  In 
practice  he  resorted  to  active  treatment,  after  the 
manner  on  Hippocrates.  He  was  a  voluminous 
writer  in  various  departments  of  medicine,  treating, 
among  other  subjects,  on  the  obstetric  art.  He  was 
the  first  to  write  commentaries  on  Hippocrates. 
Professor  Marx,  who  has  attempted  to  collect  from 
Galen  and  others,  all  that  remains  of  his  produc- 
tions, ascribes  to  him  works  bearing  the  following 
titles: — De  Causis,  Anatomia,  Disquisitiones  de 
Pulsu,  Curationes,  Commentarius  in  Hippocratis 
"  Prognostica,"  Commentarius  in  Hippocratis 
"  Aphorismos,"  Explicationes  Dictionum  Exoleta- 
rium  Hippocratis,  De  Oculis,  Digetetica.  To  which 
may  be  added,  on  the  authority  of  Soranus,  the  two 
following: — Contra  Opiniones  Vulgares,  and  De 
Arte  Obstetricia.* 

Erasistratusf  was  a  native  of  the  Isle  of  Chios. 
He  had  pursued  philosophy  under  Theophrastus, 
and  medicine  under  Chrysippus  ;  and  before  coming 
to  Alexandria,  had  distinguished  himself  by  dis- 
covering the  secret  ailment  of  young  Antiochus,  son 
of  Seleucus,  from  observing  the  acceleration  of  the 
patient's  pulse  during  the  presence  of  Stratinice,  of 
whom    he    was    enamored.       Like    his    associate, 


»  De  Herophili  Celeberrimi  Medici  Vita,  Scriptis  atque  in  Medicina  Men- 
tis By  Professor  Marx.  See  British  and  Foreign  Medical  Review,  vol.  xv. 
p.  110. 

I  Galen  and  Celsus,  a3  above. 


86  DISCOUESE. 

Erasistratus  wrote  extensively,  and  made  discoveries 
in  anatomy  and  physiology.  He  was  familiar  with 
the  general  distribution  of  the  blood-vessels.  He  de- 
scribed the  anatomical  structure  of  the  heart,  and 
like  Aristotle,  made  this  organ  the  source  both  of 
the  veins  and  arteries.  He  held  also,  in  common 
with  Aristotle,  that  the  arteries  in  health  are  filled 
with  pneuma,  or  air,  which  they  receive  from  the 
atmosphere  in  the  process  of  respiration,  and  that 
the  passage  of  blood  into  them  from  the  veins,  is 
the  usual  cause  of  disease.  He  was  familiar  with 
the  functions  of  the  nerves ;  and  as  we  are  told  by 
Ruflfus,  he  divided  them  into  nerves  of  motion  and 
nerves  of  sensation.  He  was  acquainted  with  the 
use  of  the  catheter,  and  was  probably  the  inventor 
of  that  instrument.  He  paid  no  regard  to  the  Hip- 
pocratic  doctrine  of  the  humors,  or  of  the  four  ele- 
ments. He  attributed  all  fevers  to  inflammation. 
The  inflammation  leading  to  dropsy,  he  placed  in 
the  liver  and  spleen.  The  animal  spirits  he  seated 
in  the  brain  ;  the  vital,  in  the  heart.  He  rejected 
venesection,  the  use  of  drastic  purgatives,  and  most 
other  active  medicines ;  he  treated  diseases  almost 
exclusively  by  diet  and  regimen,  and  was  among  the 
first  to  systematize  gymnastics,  or  what  would  now 
be  called  hygiene,  as  a  department  of  the  healing 
art.  Galen  speaks  of  him  as  an  accomplished  an- 
atomist, but  charges  him  with  want  of  skill  as  a 
a  physician.  After  commencing  his  anatomical  and 
physiological  researches,  he  may  have  been  too 
much  involved  in  these  to  attend  to  the  minute  de- 
tails of  practice.     He  held  medicine  to  be  a  conjee- 


DISCOURSE.  87 

tural  science.  He  was  opposed  to  the  sage  of  Cos 
on  many  points ;  was  said  to  have  been  envious  of 
Ms  reputation,  and  to  have  mentioned  him  as  rarely 
as  possible  in  his  writings. 

During  this  period  the  art  of  medicine  was  usually 
divided  into  three  parts ;  the  Dietetic,  the  Pharma- 
ceutic, and  the  Chiruro^ical.*  The  most  illustrious 
professors  of  that  branch  which  related  to  diet, 
endeavoring  to  extend  their  views,  called  in  the 
assistance  of  natural  philosophy,  being  persuaded 
that  without  this,  medicine  would  be  a  weak  and 
imperfect  science.  After  these  came  Serapion,  the 
first  of  all  to  maintain  that  the  rational  method  of 
studying  disease  was  foreign  to  the  art;  for  a 
knowledge  of  which  he  trusted  wholly  to  experi- 
ence. In  his  steps  followed  Apollonius  and  Glau- 
cias,  and  some  time  after  Ileraclides  of  Tarentium. 
And  thus  dietetics  had  its  two  parties, — one  set  of 
physicians,  rationalistic  and  pursuing  theories ;  the 
other,  following  experience  alone. 

The  pharmaceutic  branch,  though  not  rejected 
entirely  by  Erasistratus  and  his  followers,  was  more 
particularly  extolled  by  Herophilus  and  other 
rationalists,  who  resorted  to  medicine  in  all  dis- 
eases, and  some  of  whom  wrote  extensively  upon  the 
materia  medica.  Among  the  earliest  of  these  were 
Zeno,  Andreas,  and  Apollonius  surnamed  Mus,  and 
several  others  who  treated  of  medicines  incidentally. 
Among  the  less  conspicuous  writers  in  this  depart- 
ment  was  Pamphilius,   in  the    reign   of   Ptolemy 

*  Celsus. 


88  DISCOUESE. 

Philometor,  the  author  of  a  treatise  on  herbs ;  of 
which  he  speaks  in  alphabetical  order,  treating  of 
their  agricultural  as  well  as  of  their  medicinal  uses. 
Compiling  from  Hermes  ^gyptiacus,  the  great 
medical  authority  of  the  early  Egyptians,  he  dwells 
upon  the  use  of  charms,  amulets,  and  incantations 
for  increasing  the  power  of  herbs.  Nicander,  who 
flourished  in  the  same  reign,  and  spent  part  of  his 
days  at  Pergamus,  wrote  in  verse  a  treatise  on 
poisons  and  the  bites  and  stings  of  venomous  ani- 
mals. 

Among  the  surgical  writers  of  this  school,  were 
several  able  professors,  particularly  Philoxenus,  who 
treated  of  this  branch  fully,  and  with  great  accu- 
racy, in  several  volumes.  Gorgias  also,  and  Sos- 
tratus,  the  two  Herons,  the  two  Apollonii,  and 
Ammonius  Alexandrinus,  were  all  improvers  in  this 
department.  Ammonius  was  the  inventor  of  an 
instrument  for  the  crushing  of  stone  in  the  bladder, 
where  the  stone  was  too  large  to  be  extracted  in 
the  ordinary  way.  Apollonius  of  Cittium,  who 
lived  in  the  time  of  Ptolemy  Auletes  the  father  of 
Cleopatra,  was  the  author  of  a  work  on  the  diseases 
of  the  joints,  which,  though  never  printed,  is  said  to 
be  still  extant.  Philotimus,  Nileus,  and  Heraclides 
of  Tarentum,  coinciding  with  Hippocrates  and  Di- 
oles,  declare  that  they  had  perfectly  succeeded  in 
reducing  luxations  at  the  hip  joint,  a  fact  which 
others  had  called  in  question.  Andreas,  JSTymph- 
odorus,  and  Protarchus,  as  well  as  some  of  those 
already  mentioned,  were  inventors  of  machines  for 
reducing  dislocations;  diagrams  of  which  are  still 


DISCOURSE.  89 

extant  in  several  of  the  older  systems  of  surgery,  as 
well  as  in  Galen  and  Oribasius. 

Among  the  later  writers  of  this  school  who  pre- 
ceded Galen,  and  whose  works  have  descended 
to  modern  times,  were  Dioscorides  of  Anazarba, 
Kuffus  of  Ephesus,  and  probably  also  Aretseus  of 
Cappadocia.  But  of  these  we  shall  have  again 
occasion  to  speak,  in  connection  with  their  contem- 
poraries of  the  Roman  school. 

The  business  of  teaching,  at  Alexandria,  was 
never  wholly  confined  to  the  professors.  In  medi- 
cine, as  in  other  departments  of  science,  there  were 
independent  instructors.  Beyond  the  schools,  the 
student  of  medicine  appears  to  have  had  access  to 
the  temple  of  Serapis,*  which  served  in  part  as  an 
asylum  and  place  of  refuge  for  the  sick,  and  was 
used  as  such  in  the  same  way  as  the  Asclepions 
in  other  parts  of  Greece.  Nor  were  the  devices  of 
the  priests  here  less  politic  than  at  the  more  ancient 
temples  of  ^sculapius. 

As  Vespasian  was  one  day  walking  through  the 
streets  of  Alexandria  a  man  with  a  diseased  eye 
threw  himself  at  his  feet,  begging  to  be  cured,  and 
declaring  he  had  been  told  by  Serapis  that  his  sight 
would  be  restored  if  the  emperor  would  but  spit 
upon  his  eyelids.  Soon  afterwards  another  who  had 
lost  the  use  of  his  hand,  preferred  the  same  pe- 
tition ;  having  been  told  by  Serapis  that  the  emperor 
might  heal  him  by  trampling  him  under  his  feet. 

*  Le  Clerc  (Histoire  de  la  Medicine,  liv.  i.  chap.  xx.  p.  66-7,  on  the  au- 
thority of  Tacitus,  JElian  and  other  -writers),  cites  several  instances  to 
show  that  the  sick  resorted  for  relief  to  the  temple  of  Serapis. 

Y 


90  DISCOUKSE. 

Vespasian  at  first  laughed  at  their  importunity ;  but 
so  far  yielded  to  their  wishes  as  to  consult  the 
medical  faculty.  The  physicians,  like  skillful  cour- 
tiers, deemed  the  cure  by  the  means  proposed,  not 
impossible.  The  experiment  was  attempted  before 
an  assembled  multitude.  It  was  probably  as  suc- 
cessful as  the  royal  touch  of  the  kings  of  England 
and  France  in  later  times ;  and  the  flatterers  of  the 
Emperor  declared  that  he  had  healed  the  maimed, 
and  restored  the  blind  to  sight. 

Bat  the  brightest  era  of  medical  science  at  Alex- 
andria thus  far,  was  the  earliest.  Under  the  first 
associates  of  the  Museum,  anatomy  and  physiology 
were  cultivated  with  spirit  and  success  ;  and  from 
the  turn  given  to  medical  education  by  these  teach- 
ers, the  character  of  the  school  for  ages  afterwards 
was  definitely  determined.  The  Asclepiadse  of  Cos 
and  Cnidos  had  dwelt  upon  the  phenomena  of  dis- 
ease without  attempting  to  demonstrate  its  struc- 
tural relations  ;  like  the  sculptors  of  their  own  age, 
they  studied  the  changing  expression  of  vital  action 
almost  wholly  from  an  external  point  of  view.  They 
meddled  not  with  the  dead.  For,  by  their  own 
laws,  no  one  was  allowed  to  die  within  the  temple. 
But  the  early  Alexandrians  were  subject  to  no 
such  restrictions  ;  and  turning  to  good  account  the 
discoveries  of  Aristotle  in  natural  history  and  com- 
parative anatomy,  they  undertook  for  the  first  time 
to  describe  the  organization  of  the  human  frame 
from  actual  dissections  ;  and  by  applying  the  know- 
ledge thus  acquired  to  the  pathological  studies  of 
their    predecessors,  they   struck   upon    the    course 


DISCOURSE.  91 

wMch,  if  followed  out  by  their  immediate  succes- 
sors, might  have  led  to  many  early  and  brilliant 
improvements. 

But  their  successors  were  slow  in  discovering  the 
road  that  had  been  opened  to  them.  Occupied  in 
teaching  what  had  already  been  surmised  or  ascer- 
tained, few  of  them  were  ambitious  of  adding  much 
to  the  general  stock  of  knowledge.  The  dissection 
of  the  human  body  was  ^oon  abandoned,  and  the 
improvements  in  pharmacy  and  additions  .to  the 
materia  medica  introduced  by  them,  were  as  much 
due  to  the  commercial  intercourse  of  Alexandria 
with  India  and  southern  Asia,  as  to  the  scientific, 
enterprise  of  its  physicians.  So  that  medicine, 
losing  the  independent  and  progressive  character 
which  it  had  received  at  the  hands  of  Hippocrates 
and  his  early  followers,  was  again  reduced  to  a 
mere  department  of  speculative  philosophy,  in- 
volved in  futile  disputations,  and  in  formulas  based 
on  no  substantial  facts.  Hence  the  several  sects  into 
which  the  profession  in  course  of  time  became 
divided. 

Of  these  the  Dogmatists,  or  Rationalists,  claimed 
to  be  the  followers  of  Hippocrates,  and  supporters 
of  the  academic  philosophy.  The  Empirics  origi- 
nated with  Philinus,  a  pupil  of  Herophilus,  and 
with  Serapion,  the  successor  of  Philinus,  and  were 
advocates  of  the  sceptical  philosophy  of  Pyrrho. 
The  Methodists  were  of  later  date.  They  are  com- 
monly traced  to  Asclepiades,  the  founder  of  the 
Roman  school ;  but   the  lessons   of  his   instructor, 


92  DISCOTRSE. 

Cleopliantus  of  Alexandria  *  appear  to  have  fur- 
nislied  the  leading  principles  upon  which  he  and  his 
followers  founded  this  third  sect,  the  philosophy  of 
which  was  adopted  from  Epicu-rus.  The  Pneumatic 
sect  was  an  offset  from  the  Dogmatists,  and  advo- 
cated the  stoic  philosophy.  But  of  these  several 
sects,  and  of  the  Episynthetics  who  attempted  to  re- 
concile the  whole  of  them,  we  shall  have  again  occa" 
sion  to  speak,  in  connection  with  the  school  of  Rome. 
In  speaking  of  the  profession  of  his  own  time,  Galen 
classes  them  as  Herophilians  and  Erasistratians,  show- 
ing that  the  opinions  of  the  founders  of  the  Alex- 
andrian school  had  not  yet  been  superseded ;  and 
that  after  an  interval  of  more  than  five  centuries, 
the  impression  left  upon  it  by  these  great  men,  still 
continued  to  give  it  character  and  distinction.  After 
falling  under  the  sway  of  the  Romans,  for  a  century 
or  more  the  school  of  Alexandria  lost  much  of  its 
previous  celebrity,  and  is  little  spoken  of  duriog  the 
more  active  period  of  the  school  of  Rome.  Yet 
even  in  Galen's  day,  it  was  still  the  center  of  medi- 
cal science.  And  to  have  studied  medicine  at  Alex- 
andria, was  everywhere  considered  a  passport  to  the 
confidence  and  patronage  of  the  public. 

*  Celsua,  ill.  14. 


DISCOURSE.  93 


CHAPTEE      VII 


THE  SCHOOLS  OF  MEDICINE  AT  SMYRNA,  PERGAMUS, 
AND    EPIDAURUS. 


But  if  Alexandria  was  for  many  centuries  tlie 
principal  seat  of  medical  science,  there  was  perhaps 
no  period  in  which  it  was  the  only  school  open  to 
the  profession.  The  followers  of  Erasistratus,  in 
consequence  of  temporary  disturbance  at  the  Mu- 
seum, are  said  to  have  removed  to  Smyrna,  and  at 
the  Asclepion  of  that  city  to  have  established  a 
rival  institution.  It  is  even  asserted  that  the  school 
of  Smyrna  originated  with  Erasistratus  rather  than 
with  his  disciples,  and  that  he  there  spent  his  latter 
days  in  teaching. 

The  school  of  Pergamus,  as  before  remarked,  had 
been  early  celebrated.  Several  of  the  Alexandrian 
professors  also  added  luster  to  this  rival  institution. 
The  older  Heras,  who  probably  flourished  during 
the  reign  of  Attains  II.,  after  whom  the  kingdom 
passed  into  the  hands  of  the  Romans,  was  of  this 
school.  He  was  among  the  earliest,  if  not  the  first, 
to  introduce  those  compound  confections,  which, 
under  the  name  of  Theriaca,  or  antidotes,  were 
afterwards  almost  in  universal  use  among  the 
ancients.     Acopa,   or  anodyne  and   analeptic  lini- 


94r  DISCOURSE. 

ments  or  embrocations,  were  also  among  his  inven- 
tions ;  some  of  whicli  lie  honored  with  the  name  of 
his  sovereign. 

Attains  Philometor  was  not  only  the  patron  of 
the  profession,  bat  was  himself  actively  occupied  in 
the  cultivation  and  employment  of  medicinal  plants. 
We  are  told  by  Plutarch,  that  in  his  gardens  he 
planted  the  hyoscyamus,  hellebore,  cicuta,  aconite, 
and  other  poisonous  'herbs,  and  collected  them  at 
the  proper  seasons,  with  his  own  hands,  for  the  pur- 
pose of  experimenting  with  their  expressed  juice, 
their  fruit,  and  their  seed,  and  determining  their 
respective  properties.*  Attains  was  not  the  only 
sovereign  who,  about  this  epoch,  turned  occasionally 
from  the  cares  of  state  to  mingle  in  the  affairs  of  our 
profession.  Mithridates,  king  of  Pontus,  experi- 
mented with  poisonous  plants  upon  himself,  in 
order  to  habituate  himself  to  their  use,  and  thus  to 
become  unsusceptible  to  their  deleterious  effects. 
His  composition,  afterwards  known  as  the  Mithridati- 
cum,  and  employed  as  an  antidote,  was  among  the 
most  celebrated  nostrums  of  antiquity.  Pompey, 
after  overcoming  this  prince,  ordered  diligent 
search  to  be  made  among  the  archives  of  his  palace 
for  the  formula  of  this  famous  antidote ;  and  sup- 
posed he  had  discovered  it  in  a  confection  consisting 
of  rue  twenty  leaves,  salt  a  few  grains,  two  walnuts, 
and  a  couple  of  dried  figs,  which  was  to  be  taken 
fasting  every  morning,  and  followed  with  a  draught 
of  wine.f 

*  Le  Clerc,  part  ii.  liv.  iii.  chap.  iii.  p.  388-90. 
f  Seremis  Sammonicus,  v. -1064-71. 


DISCOURSE.  95 

Again,  without  referring  to  numerous  other 
places  of  less  repute,  there  is  reason  to  believe  that 
a  school  of  medicine  was  still  associated  with  that 
most  ancient  of  all  the  Asclepions,  the  temple  of 
Epidaurus  ;  which  is  said  to  have  stood  on  the  spot 
upon  which  ^sculapius  was  born,  a  promontory  on 
the  coast  of  Argolis  nearly  opposite  the  island  of 
^gina.  The  school  here  may  have  been  dispersed 
when  Sylla  ravaged  the  temple,  and  appropriated 
the  wealth  of  its  shrine  to  the  maintenance  of  his 
army  during  the  Mithridatic  war.  But  so  late  as 
the  reign  of  Antoninus  Pius,  the  temple  of  Epidaurus 
was  still  a  place  of  great  resort.  By  the  bounty  of 
this  ruler  its  accommodations  for  the  sick  were 
increased,  and  a  new  edifice  was  erected  in  its 
vicinity  for  the  accommodation  of  such  patients  as 
were  about  to  die,  and  by  the  rules  of  the  temple 
no  longer  permitted  to  remain  within  the  hallowed 
bounds.  This  new  edifice  was  also  in  part  appropri- 
ated to  parturient  women,  and  as  a  lying-in  asylum, 
sacred  to  the  services  of  Lucina.* 

*  Le  Clerc,  part  i.  liv.  L  chap.  xx.  p.  63;  and  Schulze,  p.  127,  after 
Pausanias. 


96  DISCOTJESE 


CHAPTEE    VIII. 


THE  SCHOOLS  OF  EOME. 

Section  I. — From  their  Origin  to  the  Rise  of  the  Eclectics. 

After  the  Romans  liad  acquired  the  mastery  of 
the  East,  many  adventurers  from  the  Grecian  pro- 
vinces resorted  to  the  capital  in  pursuit  of  occupa- 
tion as  teachers  and  physicians  ;  at  first,  with  small 
encouragement.  The  people  of  Rome  were  slow  in 
relinquishing  their  prejudices  against  Greek  scholars, 
and  were  indisposed  to  forget  the  humble  position 
of  those  amongst  themselves  who  were  devoted  to 
the  healing  art.*  Cato  the  Censor,  as  already  inti- 
mated, rejecting  the  sciences  not  of  native  growth, 
trusted  for  medical  assistance,  to  the  untutored  skill 
of  servants,  to  a  few  simple  preparations  from  do- 
mestic plants,  and  even  to  charms  and  incantations. 
For  curing  a  luxation  at  the  hip,  take,  says  he,  a 
green  divining  rod  four  or  five  feet  long,  split  it  in 
the  middle,  and  let  two  men  hold  it  at  the  hip  and 
begin  to  sing  :  "7;^  alio^  s,f,  motas  vceta  daries  dar- 
daries  astataries  dissunapiter^^'^  until  the  injured 
parts  are  again  united.  The  luxation  being  reduced, 
or  the  fracture  set  and  properly  adjusted  in  splints, 
repeat  the  incantation  every  day  as  at  first,  or  the 

*  Pliny,  Hist  Nat.,  lib.  xxix.  chap,  viil 


DISCOUKSE.  97 

following :  "  Huai  Jianat  Tiuat  ista  pista  sista  domin- 
abo  damnaustra  f  or  after  this  manner:  ^'' Huat 
Tiaut  Jiaut  ista  sis  tar  sis  ardannahon  dunnaustra.^''  * 

We  have  already  alluded  to  the  earliest  temple 
of  ^sculapius  among  the  Romans,  that  upon  the 
Island  of  the  Tiber.  Others  were  afterwards  erected 
in  the  city ;  one  of  these,  according  to  Serenus  Sam- 
monicuSjf  was  situated  on  the  Tarpeian  rock. 

But  indications  of  a  more  enlightened  spirit, 
are  apparent  towards  the  decline  of  the  republic. 
As  early  as  the  time  of  Caius  Marius,  the  city 
was  well  supplied  with  hardy  and  enterprising  prac- 
titioners. This  veteran  warrior,  who  had  been  six 
times  consul,  underwent  at  the  hands  of  one  of 
»  these,  an  operation  for  the  cure  of  varices  ;  and  after 
the  diseased  veins  had  been  forcibly  wrenched  from 
beneath  the  skin  of  one  leg,  he  refused  to  present 
the  other  limb,  judging  from  what  he  had  already 
experienced,  that  the  proposed  relief  could  hardly 
compensate  for  the  suffering.  J 

Still  nearer  the  close  of  the  republic,  the  Greek 
physicians  of  the  city  had  risen  to  the  confidence 
and  friendship  of  the  Patricians.  Caesar  on  his  voy- 
age to  Rhodes,  when  taken  prisoner  by  the  pirates 
near  the  island  of  Pharmaceusa,  was  accompanied, 
among  other  friends,  by  his  physician. §  Cicero  de- 
clares it  to  be  the  duty  of  all  men — a  duty  particu- 
larly incumbent  on  himself — to  support  the  dignity 
of  the  healing  art.     "  Licet  enim  omnibus^  licet  enim 


*  M.  Porcius  Cato  de  ReRustica,  cap.  clx.  f  Verse  10th. 

\  Pliny,  lib.  xi.  cap.  104.  §  Suetonius,  cap.  iv. 


08 


DISCOURSE. 


mihi^  dignitatem  medim  artis  tueriP  And  to  Ascle- 
piades,  then  the  most  popular  physician  of  the  city, 
he  alludes  as  his  personal  friend,  celebrated  as  much 
for  his  refined  eloquence  as  for  his  skill  in  physic* 

In  the  time  of  Cicero,  the  study  of  philosophy  had 
already  become  essential  to  what  was  considered  an 
accomplished  education.  This  study  implied  an  ac- 
quaintance with  the  Greek  language,  and  was  im- 
perceptibly attracting  attention  to  medicine,  from 
which  the  teachers  of  philosophy  were  in  the  habit 
of  deriving  their  aptest  illustrations,  and  with  which 
their  own  doctrines  were  inseparably  united.  The 
statesmen  and  orators  of  the  nation,  becoming  in 
youth  familiar  with  medicine  as  a  department  of 
philosophy,  began  at  length  to  respect  it  as  an  art, 
and  to  give  to  its  professors  their  protection  and  en- 
couragement. Hence  the  various  laws  introduced 
soon  after  the  organization  of  the  empire,  for  the 
benefit  of  the  profession. 

Caesar,  after  reaching  the  summit  of  his  power,  in 
order  to  attract  men  of  science  to  the  capital,  and 
to  improve  the  condition  of  those  already  there,  de- 
creed that  all  who  practiced  physic  at  Eome,  and 
all  the  masters  of  the  liberal  arts  therein  residing, 
should  enjoy  the  privilege  of  citizenship.f  And 
Augustus,  after  having  been  relieved  of  a  danger- 
ous illness  by  his  freed-man,  Antonius  Musa,  loaded 
this  physician  with  wealth ;  raised  him,  by  consent 
of  the  Senate,  to  the  equestrian  rank;  erected  a 
bronze  statue  to  his  honor  near  that  of  ^sculapius  ; 

*  De  Oratore.  f  Suetonius,  Julius  C^sar,  cap.  xlii. 


DISCOURSE.  99 

and,  at  his  instigation,  conferred  important  privi- 
leges on  the  whole  body  of  the  profession  then 
residing  in  the  city.*  Thes  e  privileges  were  after- 
wards confirmed  and  extended  by  Vespasian,  Ad- 
rian, Antoninus  Pius,  Domitian,  Alexander  Severus, 
and  other  later  emperors. 

Asclepiades,  the  friend  of  Cicero  already  men- 
tioned, was  a  native  of  Prussa  in  Bithynia.  To  him, 
more  than  to  any  other  individual,  belongs  the 
credit  of  having  first  raised  the  medical  profession 
in  Rome  to  the  confidence  and  respect  of  the  peo- 
ple.f  Educated  under  Cleophantus  at  Alexandria, 
he  had  practiced  medicine,  and  been  employed  as  a 
teacher  of  elocution  at  Athens,  and  other  parts  of 
Greece,  before  taking  up  his  abode  in  Rome.  Of  an 
acute  and  discerning  mind,  he  soon  discovered  that 
the  principal  source  of  mistrust  towards  those  who 
who  had  preceded  him,  lay  in  their  crude  and  un- 
feeling practice.  And  though  at  this  time  perhaps 
not  deeply  versed  in  the  principles  of  his  art,  he 
saw  the  advantage  of  instituting  an  entirely  difi*er- 
ent  course.  Accordingly,  rejecting  most  internal 
medicines  as  liable  to  offend  the  stomach,  he  con- 
fined himself  principally  to  hygienic  measures,  and 
to  regulating  the  diet.  To  enforce  his  own  views, 
he  turned  his  eloquence  to  good  account  as  a  public 
teacher,  and  originated  the  first  school  of  medi- 
cine in  the  city.  He  was  the  author  of  a  treatise 
on  General  Remedies,  in  which  he  dwelt  mainly  on 
friction  of  the  skin,  and  beyond  this,  only  on  pas- 

*  Seutonius,  Octav.  August.,  cap.  lix. 
_    f  See  Cassius,  Celsus,  Cselius  Aurelianus,  Pliny,  Apuleius  Madaurensis. 


100  DISCOURSE. 

sive  exercise,  and  tlie  use  of  wine.  The  novelty  and 
attractive  character  of  his  practice  rendered  him 
popular,  and  secured  to  him  lucrative  occupation, 
from  which  he  accumulated  a  princely  fortune. 
Adopting  the  atomic  philosophy  of  Epicurus,  he  at- 
tributed all  diseases  to  obstruction  of  the  primary 
atoms  in  their  passage  through  the  invisible  pores  ; 
and  the  restoration  of  these  atoms  to  their  equable 
relation  to  the  pores,  so  as  to  move  without  embar- 
rassment, he  made  the  principal  indication  in  his 
treatment.  This  theory  was  afterwards  more  fully 
elaborated  by  his  successors,  in  whose  hands  it  was 
expanded  into  the  distinctive  doctrine  of  the 
Methodic  sect. 

The  merits  of  Asclepiades  as  a  reformer,  have 
been  differently  estimated  by  different  writers,  some 
looking  upon  him  as  little  more  than  a  successful 
charlatan,  others  as  a  philosophical  physician. 
Apuleius  M  adaurensis  declares  him  superior  to  all 
other  physicians,  Hippocrates  only  excepted.^  Ga- 
len charges  him  with  many  absurdities,f  and  with 
having  but  little  knowledge  of  the  great  fathers  of 
the  profession,  whom  he  affected  to  ridicule ;  for  he 
had  characterized  even  the  writings  of  Hippocrates 
as  a  meditation  upon  the  dead.  But  Celsus,J  his 
more  moderate  defender,  declares  he  was  the  first 
after  Heraclides  of  Tarentum,  to  effect  important 
improvements  in  the  healing  art ;  and  yet  admits 
that  he  assumed  as  his  own,  the  use  of  friction  as  a 


*  Florida,  cap.  xix. 

f  VoL  ii,  p.  165,  and  elsewhere  in  numerous  places. 

I  Preface  to  first  book. 


DISCOURSE.  101 

therapeutic  agent,  to  wMcli  lie  had  no  claim,  inas- 
much as  it  had  been  in  use  since  the  time  of  Hip- 
pocrates ;  adding,  however,  that  Asclepiades  had 
treated  of  this  more  fully  and  clearly  than  any 
former  writer.  To  him  we  owe  the  aphoristic 
phrase,  "  Tato^  cito^  ut  jucunde^'^  or,  as  given  by  Cel- 
sus,  ^''Asclepiades  officium  esse  medici  dicit^  ut  tuto^ 
ut  celeriter^  ut  jucunde  curety  He  was  the  first  to 
announce  the  doctrine  of  the  self-limitation  of  dis- 
ease, asserting  that  the  principal  cure  for  a  fever 
was  the  disease  itself.  He  wrote  on  ulcers,  and  on 
acute  and  chronic  diseases.  He  recommended  tra- 
cheotomy in  threatened  suffocation.*  His  claim  to 
our  respect  appears  to  lie  in  his  rejection  of  the  com- 
plex, violent,  and  perturbing  remedies  in  use  before 
his  day,  and  substituting  for  them  such  as  were 
simple  and  grateful  to  the  sick;  and  in  looking 
upon  his  art  as  useful  only  so  far  as  it  served  to 
alleviate  actual  suffering,  or  to  administer  consola- 
tion to  his  patients.  Remarkable  for  independence 
of  judgment,  and  for  a  certain  elevation  of  charac- 
ter, he  would  have  the  presence  of  the  physician  a 
source  of  pleasure  and  encouragement  to  the  patient 
rather  than  of  foreboding  and  mistrust,  and  the  phy- 
sician himself  to  perform  the  double  function  of  cur- 
ing disease  as  became  a  skillful  and  compassionate 
practitioner,  and  of  cheering  and  amusing  the  sick 
as  became  a  friend.  He  settled  at  Rome  in  the  time 
of  Pompey,  about  63  years  before  the  birth  of 
Christ ;  and  he  is  said  to  have  been  killed  by  a  fall 
from  a  ladder  in  his  extreme  old  age. 

*  Cassius,  Cselius  Aurelianus,  and  Galen,  vol.  siv.  p.  2*74,  Kuhn's  edition. 


102  DISCOURSE. 

Antonius  Musa,  who  was  so  higlily  honored  by 
Augustus  and  the  Roman  Senate,  is  spoken  of  as  an 
able  and  judicious  writer.  According  to  Pliny*  he 
owed  his  first  success  to  having  recommended  to  Au- 
gustus the  use  of  lettuce,  which  his  former  attendant, 
Camilius,  had  prohibited.  He  was  an  advocate  for 
the  cold  bath  as  a  means  of  restringing  the  pores ; 
a  practice  which  at  this  time  appears  to  have  been 
considered  an  innovation ;  and  the  cure  of  Augustus, 
according  to  Suetonius,-}-  was  effected  by  substitut- 
ing cold  instead  of  warm  applications.  A  small 
treatise  attributed  to  him,  and  dedicated  to  Marcus 
Agrippa,  the  son-in-law  of  Augustus,  is  still  extant. 
It  is  entitled  ^'  De  Herba  Vetonica,"J  and,  in  the 
short  space  of  eight  octavo  pages,  treats  of  this  plant 
in  its  application  to  forty-seven  different  ailments. 
This  little  work  is  in  Latin,  although  its  author,  like 
most  of  the  physicians  of  the  time,  was  probably  a 
Greek.  His  brother  was  highly  esteemed  by  Juba 
H.,  king  of  Numidia,  who  was  himself  a  man  of  great 
learning,  and  the  author  of  the  first  Greek  history 
of  Eome ;  and  who,  on  discovering  a  new  medicinal 
plant  near  Mount  Atlas,  named  it  after  this  physi- 
cian ;  and  it  is  still  known  by  the  name  first  as- 
signed to  it,  the  Euphorbia.§ 

Cassius,  of  whom  Celsus  speaks  as  recently  dead, 
and  as  the  most  ingenious  physician  of  his  age,  must 


*  Kat.  Hist.  lib.  xix.  cap.  xxxviii. 
I  Suetonius,  Octav.  August.,  cap.  Ixxxiii. 

^  Liber  Antonii  Musee  de  Herba  Vetoniea,  et  liber  Apuleii  de  Medica- 
mentibus  Heibarum.     Per  Gabrielem  Humelbergium,  Basilese,  8vo.  1536. 
§  Plinj-,  Xat.  Hist  lib.  xxr.  cap.  xxxviii. 


DISCOURSE.  103 

have  been  among  the  early  followers  of  Asclepiades. 
Thousfh  an  admirer  of  the  doctrines  of  this  refor- 
mer,  he  was  an  independent  observer,  w"edded  to 
no  exclusive  hypothesis.  In  his  practice,  he  in- 
quired not  merely  whether  the  pores  are  bound  or 
loose,  but  rather,  what  is  the  exciting  cause  of  dis- 
ease. When  called  to  a  patient  in  a  fever  and 
suffering  excessive  thirst  from  free  indulgence  in 
wine,  he  ordered  him  to  drink  plentifully  of  cold 
water  ;  which,  by  weakening  the  force  of  the  wine, 
induced  sleep  and  perspiration,  and  in  this  way  dis- 
sipated the  disease.  He  was  the  author  of  a  small 
work  entitled  "  Medical  Problems,"^'  which  is  still 
preserved,  and  is  highly  deserving  of  perusal,  as 
illustrating  the  style  of  medical  logic  at  this  epoch. 

This  interesting  treatise  consists  of  eighty-four 
distinct  problems,  with  their  solutions,  all  briefly 
handled,  and  most  of  them  relating  to  the  his- 
tory and  treatment  of  disease.  In  the  first  of 
these  problems  the  author  asks,  why  are  round 
ulcers  the  most  difficult  to  cure ;  and,  in  reply,  cites 
the  mathematical  reason  of  Herophilus  and  his  fol- 
lowers, as  well  as  that  of  Asclepiades ;  who,  as  we 
here  learn,  had  taught  that  ulcers  of  this  shape  may 
be  induced  to  heal  by  approximating  their  edges  so 
as  to  change  their  shape,  or  by  incising  their  edges 
with  a  scalpel.  And  in  the  fortieth  problem  we  learn 
that  Asclepiades  was  the  author  of  a  distinct  work 
on  ulcers. 

In  problem  sixth,  Cassius  inquires,  why  are  per- 

*  Cassii  Medici  Questione3  et  Problemata,  Adriano  Junio  Homano,  in- 
terprete.    Medicinsa  Artia  Principes.     Venetiis,  folio,  156V. 


104:  DISCOIJESE. 

sons  with  disease  of  tlie  liver,  spleen,  or  lungs,  most 
disposed  to  lie  on  the  affected  side.  His  answer  is 
based  on  anatomical  reasoning,  and  is  the  same  that 
would  be  given  at  the  present  day.  His  problems 
relating  to  diseases  and  injuries  of  the  head,  evince 
considerable  anatomical  and  physiological  acquire- 
ments. In  problem  fortieth,  he  asks  why  parts 
around  the  seat  of  injury  on  a  limb,  may  remain  un- 
affected, whilst  those  remote  from  it  are  apt  to  suf- 
fer; as  the  groin,  for  example,  after  injury  of  the 
foot;  the  glands  of  the  neck  after  wounds  of  the 
head;  or  axillary  buboes  after  ulcerations  of  the 
hand.  In  resolving  this  inquiry,  he  differs  from  As- 
clepiades,  and  attributes  the  remote  affection  to  the 
influence  of  the  nerves  ;  which,  says  he,  are  of  all 
the  organs  the  most  disposed  to  participate  in  the 
diseases  of  the  members  with  which  they  act  in 
concert.  In  the  next  problem  he  asks  why  injury 
of  the  meninges  on  one  side  of  the  head,  is  fol- 
lowed by  paralysis  on  the  opposite  side  of  the  body ; 
and,  in  reply,  refers  to  the  anatomy  of  the  nerves, 
which,  says  he,  derive  their  origin  from  the  base  of 
the  brain,  where  those  of  the  two  sides  decussate, 
so  that  those  from  the  right  side  of  the  base  pass 
into  the  left  sinus  of  the  head,  and  vice  versa.  In 
the  forty-third,  he  asks  why  papulae  arise  from  a 
burn  on  a  living,  and  not  on  a  dead  surface -and 
his  reply  is,  that  in  dead  bodies  the  spirits  are  ex- 
tinct, whilst  in  the  living,  they  are  moving  about 
and  universally  disseminated.  In  the  fifty-sixth,  he 
asks,  why  infants  suffer  most  severely  from  fever ; 
and  tells  us  that  in  them  there  is  a  superabundance 


BISCOITESE.  105 

of  native  heat.  In  the  sixty-seventh,  he  inquires, 
why  do  fevers  modify  the  condition  of  the  pulse ; 
and  in  reply,  he  states  that  when  the  equilibrium  of 
the  innate  spirit  is  disturbed,  and  it  is  separated 
from  the  natural  spirit,  it  superabounds  and  becomes 
attenuated  and  divided  by  the  intrinsic  heat,  so  that 
by  its  lightness  it  acquires  increased  celerity,  and 
thus  affects  not  only  the  pulse  but  also  the  respira- 
tion. Here  he  is  foreshadowing  the  doctrines  of 
the  pneumatic  sect,  though  perhaps  only  in  expo- 
sition of  the  views  previously  advanced  by  Erasis- 
tratus,  and  even  by  Hippocrates.  In  the  sixty-eighth 
problem  he  inquires  why  persons  laboring  under  fe- 
ver, are  subject  to  superficial  ulcerations  on  the  skin. 
This  question  is  remarkable,  and  might  lead  to  the 
belief  that  this  acute  and  inquisitive  observer  must 
have  been  familiar  with  the  eruptive  fevers. 

It  has  been  questioned  whether  or  not  the  au- 
thor of  these  problems  was  identical  with  the  Cas- 
sius  mentioned  by  Celsus.  But  there  is  nothing 
in  the  work  itself  to  throw  doubt  upon  this  point. 
Its  author  must  have  been  worthy  of  the  character 
which  his  junior  contemporary  has  bestowed  upon 
him.  There  is  no  allusion  in  the  work  to  any  writer 
later  than  Asclepiades ;  besides  whom  and  Herophi- 
lus,  it  mentions  only  Andreas  Carystus,  an  Alex- 
andrian writer  on  certain  articles  of  the  materia 
medica. 

About  this  time  there  were  residing  and  practi- 
cing at  Rome,  several  professors  of  surgery  of  no 
small  note,  among  whom  were  the  elder  Tryphon, 
Euelpistus,  the  son  of  Phleges,  and  Meges,  who, 
8 


106  DISCOTJRSEr 

says  Celsus,  was  the  most  learned  of  them  all,  as 
shown  by  his  writings.  This  latter  was  the  inven- 
tor of  an  instrument  for  incising  the  neck  of  the 
bladder,  in  the  operation  for  vesical  calculus ;  which 
instrument,  judging  from  Celsus'  account  of  it,  must 
Have  been  a  double-cutting  gorget,  similar  to  what 
in  this  country  has  recently  been  described  as  the 
lithotome  of  Bushe,  or  prostatic  bisector  of  Dr.  Ste- 
vens, cutting  transversely.  Meges,  also,  contrary  to 
the  general  belief,  proved  the  possibility  of  anterior 
luxation  of  the  tibia  at  the  knee  joint,  by  a  success- 
ful case  which  he  himself  had  treated.  In  the 
pathology  of  abscesses,  he  was  in  advance  of  his 
times ;  for  while  the  general  belief  then  was,  that 
all  investing  coats  and  sheaths  were  nervous,  he 
affirmed  that  a  nerve  was  never  generated  in  a  dis- 
order which  destroyed  the  flesh ;  but  that  the  pus 
being  lodged  below  for  a  long  time,  became  sur- 
rounded with  a  simple  callosity.  Some  of  the  fore- 
going were  also  distinguished  as  oculists.* 

As  yet,  the  only  two  sects  recognized  in  the  pro- 
fession, were  the  E-ationalists  and  the  Empirics  ;f 
for,  though  Asclepiades  had  introduced  important 
innovations,  he  was  still  classed  as  a  Eationalist. 
Nor  was  Celsus  willing  that  even  the  followers  of 
Theraison  should  be  acknowledged  as  a  third  sect. 

The  Rationalists  were  those  who  declared  for  a 
theory  in  medicine,  and  held  as  essential  to  the 
proper  management  of  diseases,  that  the  physician 
should  inquire  into  their  occult  or  constituent  causes, 

*  Celsus,  in  different  places.  f  Ibid,  book  i.,  preface. 


DISCOURSE.  107 

and  their  evident  or  exciting  causes,  and  that  he 
should  be  acquainted  with  the  natural  actions  of  the 
body  and  its  internal  organization.    By  occult  or  con- 
stituent causes,  they  unders/ood  such  as  are  derived 
from  the  elements  composing  the  body.     By  evi- 
dent causes,  they  referred  to  such  as  are  adventi- 
tious and  apparent,  as  1/eat,  cold,  fasting,  a  surfeit, 
fatigue,  and  the  like,  ?vhich  are  operative   at  the 
incipient,  if  not  also  m  the  latter  stages  of  a  dis- 
temper.     By  natural  actions  they  understood   the 
functions  of  respiration,  reception  and  concoction  of 
food  and  drink,  and  the  distribution  of  the  nutri- 
ment throughout  the  body.     They  also  investigated 
the    causes,   mo(?ifications,  and  indications   of   the 
pulse,  and  wh^t   gives  rise  to  sleep   and   waking. 
They  urged  tie  necessity  of  modifying  the  treat- 
ment of  dise^e  in  accordance  with  the  character  of 
the  occult  aiuse.     But  they  differed  among  them- 
selves as  t/>  what  should  be  considered  the  occult 
cause.     8(/me  of  them,  in  common  with  Empedocles 
and  the  ^arly  philosophers,  held  it  to  consist  in  re- 
dundan^^e  or  deficiency  in  one  or  more  of  the  four 
primitive     elements, — fire,   air,    earth,   and    water. 
Some  of  them,  with  Herophilus  and  other   earlier 
writers,  maintained  that  it  lay  in  a  faulty  condition  of 
the  four  humors — phlegm,  blood,  bile,  and  atrabile  ; 
others,  with  Hippocrates,  attributed  it  to  the  quali- 
ties of  the  inspired  air ;    some,  with  Erasistratus, 
ascribed  it  to  the  escape  of  blood  from  the  veins  (or 
vessels  designed  only  for  blood),  into  the  ai-teries, 
which  they  believed  were  designed  only  for  air  and 
spirits  ;  the  escape  of  blood  in  this  way,  giving  rise 


108  DISCOIJESE. 

to   inflammation,    aad   tlirough   this,   to   a    fever. 
Others  again,  accepting  the  new  doctrine  of  Ascle- 
piades,  placed  the  occult  cause  of   all  diseases  in 
the  interruption  or  arrest  of  the  minute  corpuscles 
in  their  passage  through  the  invisible  pores.     They 
all,  too,  maintained  the  importance  of  a  correct 
knowledge  of   concoction;    but  here  again,  their 
opinions  varied ;  some  of  them  affirming,  with  Erasis- 1 
tratus,  that  in  the  stomach  tae  food  is  concocted  by''- 
attrition;    others,  with  Plistcnicus,  the  disciple  of 
Praxagoras,  that    it   is   effected   by   putrefaction ; 
others,  upon  the  authority  of  Hippocrates,  that  it 
should  be  ascribed  to  the  effec^.s  of  heat ;  whilst 
the  disciples  of  Asclepiades,  looking  upon  all  these 
opinions   as    futile    speculations,   i?iaintained    that 
there  is  no  such  function   as  concoction,  but  that 
the  food  and  drink  in  their  crude  s.ate  are  distri- 
buted, by  means  of  the  pores,  throughout  the  body. 
They  all  held  to  the  importance  of  aiatomy  and 
correct  knowledge  of  the  internal  organization  of 
the   body,    and   maintained   that    Herophilus   and 
Erasistratus  had  taken  the  best  means  for  ecquiring 
such  knowledge,  in  procuring  criminals  from  the 
prisons  by  royal  consent,  and  dissecting  them  alive, 
so  as  to  contemplate,  while  yet  living,  those  parts 
which  nature  has  concealed.     And  they  declared  it 
was  by  no  means  cruel,  by  the  torture  of  a  few 
criminals,  to  search  after  remedies  for  the  whole 
innocent  race  of  mankind  in  all  ages. 

The  Empirics,  on  the  other  hand,  relied  on  per- 
sonal experience  alone.  They,  indeed,  admitted  the 
advantages  of   occasionally   studying   the   evident 


DISCOURSE.  109 

causes  ;  but  to  searcli  after  the  occult  causes,  or  tlie 
natural  actions,  they  believed  to  be  useless ;  because 
nature  is  incomprehensible,  as  shown  even  by  the  dis- 
cussions of  the  philosophers ;  who,  if  reasoning  were 
of  much  avail,  ought  to  be  the  ablest  physicians; 
whereas  they  have  abundance  of  words,  but  very 
little  skill  in  healing.  All  theories  as  to  causes,  said 
they,  are  of  little  account,  seeing  that  men  of  opposite 
theories  were  about  equally  successful  in  the  treat- 
ment of  disease,  and  that  whatever  be  the  charac- 
ter of  these  causes,  the  diseases  require  to  be  differ- 
ently treated  in  different  places  and  different  seasons. 
Again,  even  where  the  apparent  cause  is  recognized, 
as  in  lippitude,  a  wound,  or  ulcer,  it  does  of  itself 
point  to  the  means  of  cure.  And  if  the  evident 
cause  do  not  suggest  these  means,  much  less  can  the 
other,  which  is  itself  obscure.  They  held  that 
medicine  was  not  the  result  of  reasoning,  but  that 
theory  was  invented  after  the  remedy  had  been  em- 
ployed, and  for  explaining  its  effects.  They  asked, 
too,  whether  reason  prescribes  the  same  things  as 
experience,  or  different ;  for,  if  the  same,  it  is  need- 
less ;  if  different,  mischievous.  On  the  appearance 
of  any  new  disease,  instead  of  inquiring  into  its  oc- 
cult or  apparent  causes,  they  sought  for  its  an- 
alogy to  diseases  already  known,  and  met  it  by 
remedies  analogous  to  such  as  were  used  in  these, 
until  the  true  mode  of  treatment  could  be  dis- 
covered. They  did  not  affirm  that  judgment  is  un- 
necessary, but  that  conjecture  is  of  no  use,  and  that 
it  is  of  little  consequence  how  the  disease  originates, 
so  long  as  we  are  able  to  cure  it.     They  admit 


110  DISCOURSE. 

that  in  all  discussions  of  this  sort,  mucli  may  be  said 
on  both  sides ;  yet,  that  diseases  are  not  to  be  cured 
by  eloquence,  but  by  remedies.  They  regarded  as 
useless  the  study  of  the  natural  actions  and  internal 
organization  of  the  body ;  and  they  denounced  the 
dissection  of  living  men  with  as  much  vehemence  as 
would  the  moralist  of  modern  times. 

Thus  stood  the  discussion,  which  had  been  handled 
with  great  warmth  for  many  ages,  when  Themison 
of  Laodicea,  the  disciple  and  successor  of  Ascle- 
piades,  entered  the  lists  in  his  old  age,  as  the 
leader  of  a  third  party."^  Though  he  was  influ- 
ential as  a  teacher  and  reformer,  his  writings  are 
not  often  quoted ;  and  as  they  have  perished  in  the 
wreck  of  ages,  his  opinions  are  known  to  us  only 
through  his  reputed  followers,  or  the  critics  and 
historians  who  have  noticed  them.  According  to 
Cselius  Aurelianus,  he  was  the  first  to  write  syste- 
matically on  the  management  of  chronic  diseases, 
upon  which  subject  he  published  a  work  in  three 
books.  He  wrote  also  on  acute  diseases.  As  a 
practitioner  he  was  familiar  with  the  use  of  opium, 
hyoscyamus,  and  other  narcotics ;  and  his  name  is 
associated  with  a  confection  of  poppies,  which  he 
employed  in  the  diseases  of  the  respiratory  organs. 
But  he  is  more  especially  worthy  of  notice  as  the 
founder  of  the  Methodic  Sect. 

Adopting  the  theory  of  Asclepiades  as  to  the  arrest 
of  the  ultimate  molecules  in  the  invisible  pores,  he 


*  Celsus,  book  i.  preface ;  Galen  and   Cselius  Aurelianus,   at  several 
places. 


DISCOURSE.  Ill 

attributed  all  diseases  to  excessive  tension  or  relaxa- 
ation;  and  tliis  doctrine  of  Laxum  and  Strictum 
became  the  essential  principle  of  the  new  party  ; 
who,  with  the  Empirics,  abandoned  th€  study  of 
exciting  causes,  as  having  no  relation  whatever  to 
the  method  of  cure ;  and  maintained  that  the  cor- 
rect method  of  treating  disease  may  be  ascertained 
by  simply  observing  a  few  of  its  general  symptoms. 
Of  distempers  they  made  three  kinds,  the  bound, 
the  loose,  and  the  mixture  of  these  two,  according 
as  the  excretions  are  too  scanty,  too  profuse,  or  some 
particular  excretions  are  deficient  whilst  the  others 
are  in  excess.  These  several  forms  they  subdivided 
into  the  acute  and  chronic,  and,  also,  according  as 
they  were  increasing,  stationary,  or  receding.  Their 
rule  of  treatment  was,  that  the  body  if  bound, 
should  be  opened ;  if  relaxed,  it  should  be  astringed ; 
and  if  the  distemper  were  complex,  the  most  urgent 
ailment  should  be  the  first  opposed  ;  varying  the 
agent  with  the  duration  or  stage  of  the  disease. 
The  observance  of  these  rules  constituted,  accord- 
ing to  their  notion,  the  whole  art  of  medicine  ;  and 
from  their  own  established  w^ay  of  proceeding  by 
method,  they  claimed  for  themselves  the  name  of 
Methodists  ;  for  they  differed  from  the  Eationalists, 
in  not  allowing  medicine  to  consist  in  theorizing 
about  occult  or  other  causes, — and  from  the  Em- 
pirics, in  holding  personal  experience  to  be  but  a 
small  part  of  the  art.  The  doctrine  of  the  Meth- 
odists had  for  a  time  great  sway.  Celsus,  while 
criticising  them    with   his    accustomed    acuteness, 


112  DISCOURSE. 

gives  them  but  little  countenance,  and  denies  their 
claim  to  the  title  of  a  distinct  sect. 

Aulus  Cornelius  Celsus,  justly  styled  the  Latin 
Hippocrates,  was  the  junior  contemporary  of 
Themison,  and  so  far  as  we  are  aware,  the  earliest 
medical  writer  of  unequivocal  Roman  birth.*  Of 
his  own  personal  history  little  is  known.  Quin- 
tilian  attributes  to  him  a  treatise  upon  Rhetoric, 
and  gives  honorable  testimony  to  the  extent  of  his 
learning.  His  contemporary  Columella,f  who  often 
quotes  from  his  work  on  agriculture,  with  great 
deference  to  his  authority,  equals  him  to  the  ablest 
writers  on  husbandry,  and  speaks  of  him  as  one 
not  only  skilled  in  agriculture,  but  who  had  fa- 
miliarized himself  with  the  whole  compass  of  natural 
knowledge.  His  treatise  on  Medicine,;];  in  eight 
books,  is  all  that  now  remains  of  his  writings. 
According  to  the  best  critics,  this  work  must  have 
been  written  towards  the  close  of  the  reign  of 
Augustus,  or,  at  latest,  at  the  beginning  of  the  reign 
of  Tiberius.  Celsus,  more  than  any  other  of  the 
ancient  Latin  physicians,  is  celebrated  for  the  purity 
and  elegance  of  his  style,  and  for  a  concise  and 
judicious  manner  of  handling  his  subject.  The 
summary  history  of  medical  doctrines,  of  the  ma- 
teria  medica,   and   of  surgery,   introduced  at  the 


*  Columella,  Pliny,  and  Quintilian,  all  speak  of  him  as  a  Roman. 

f  De  Re  Rustiea,  lib.  i.  cap.  1,  €t  seq. 

\  A.  Corn.  Celsi  Medicinpe  lib.  octo.  ex  recensione  Leonard!  Targa?,  <fec. 
Edinburg,  8vo.  1831.  See  also  the  translation  of  the  same,  by  James 
Greive,  M.  D.     3d  edition.     London,  183Y. 


DISCOURSE.  113 

commencement  of  his  first,  fiftli,  and  seventli  books, 
shows  how  carefully  he  had  studied  the  great  mas- 
ters of  the  art,  and  how  well  he  was  prepared  to 
furnish  a  thorough  and  reliable  digest  of  their 
opinions  ;  not  indeed  as  a  compiler  of  minute  details, 
but  as  one  able  to  grasp  the  philosophy  of  medi- 
cine, and  at  the  same  time  not  to  overlook  any  facts 
essential  to  the  guidance  of  the  practitioner.  While 
citing  many  authors,  he  holds  Hippocrates,  and 
next  to  him  Asclepiades,  in  chief  regard.  In  judg- 
ment he  is  too  independent  to  acquiesce  in  all  that 
had  been  advanced  by  either  of  these.  He  rejects 
the  Hippocratic  doctrine  of  critical  days,  and  he 
differs  from  Asclepiades  in  many  points  ;  but  whilst 
dissenting  from  those  whose  authority  he  usually 
respects,  he  gives  sufficient  reason  for  his  own 
opinions.  The  delicacy  of  his  censure  in  condemn- 
ing others,  and  the  caution  with  which  he  avoids 
all  allusion  to  himself,  have  led  some  to  the  belief 
that  he  was  not  a  practitioner  of  medicine.  But, 
as  his  translator  Dr.  Grieve  has  well  remarked,  his 
forms  of  expression  are  those  of  a  practitioner,  and 
such  as  would  come  very  improperly  from  a  mere 
compiler.  To  the  careful  student  of  his  works,  it 
must  appear  incredible  that  a  production  so  replete 
with  practical  suggestions,  and  so  remarkable  for 
medical  discernment,  could  have  been  the  work  of 
any  other  than  an  accomplished  and  skillful  phys- 
ician. He  may  not  indeed,  like  the  Greeks  of 
Rome,  have  practiced  for  a  livelihood.  "  The  man 
to  be  trusted,"  he  tells  us,  "  is  he  who  knows  his 
profession,  and  is  not  much  absent  from  his  patient. 


114:  DISCOURSE. 

But  they  who  practice  only  from  views  of  gain  *  * 
readily  fall  in  with  such  rules  as  do  not  require 
close  attention.  *  *  It  is  easy  for  such  as  seldom 
see  the  patient  to  count  the  days  and  paroxyms ; 
but  for  him  who  would  form  a  true  judgment  of 
what  is  alone  fit  to  be  done,  it  will  be  necessary  to 
sit  by  his  patient."*  The  inference  to  be  derived 
from  this  passage,  as  well  as  from  his  literary  habits 
and  polished  style,  is  that  he  may  have  been  in 
easy  circumstances,  above  the  necessity  of  practicing 
for  the  sake  of  gain,  and  that  he  followed  his  profes- 
sion as  a  liberal  and  useful  occupation,  as  law  had 
originally  been  followed  by  the  patricians  and  other 
men  of  influence  at  Eome  ;  who,  even  in  the  days 
of  Cicero,  would  have  considered  it  disgraceful  to 
accept  a  fee  from  the  client  in  whose  behalf  they 
"were  officiating  as  advocates  at  the  forum. 

The  early  Alexandrian  division  of  diseases,  into 
such  as  are  remedial  by  diet  and  regimen  alone, 
such  as  require  the  use  of  medicines,  and  such  as  call 
for  the  interference  of  surgery,  is  that  which  Celsus 
adopts  as  the  basis  of  his  arrangement  for  treating 
on  every  branch  of  medicine  then  understood.  In 
his  first  book,  he  dwells  with  sufficient  fullness  on 
the  general  rules  of  health ;  in  the  second,  on  -gen- 
eral pathology  and  therapeutics ;  in  the  third  and 
fourth,  he  speaks  of  such  individual  diseases  as  affect 
the  whole  body,  and  such  as  occur  on  particular 
parts,  and  are  remediable  by  diet;  in  the  fifth 
and  sixth,  of  such  constitutional  and  local  diseases 

*  Lib.  iii.  cap.  4. 


DISCOUKSE.  115 

as  require  tlie  assistance  of  medicine  ;  most  of  the 
sixtli  book  is  taken  up  with  diseases  properly  surgi- 
cal, though  not  requiring  operations ;  and  in  the  two 
remaining  books,  he  gives  a  systematic  exposition  of 
surgery;  the  last  book  being  occupied  exclusively 
with  diseases  and  injuries  of  the  bones  and  joints. 
We  have  already  had  occasion  to  condense  from 
the  preface  to  his  first  book,  his  exposition  of  the 
opinions  and  arguments  of  the  Rationalists  and 
Empirics.  The  following  are  his  own  views  on  the 
merits  of  the  whole  discussion  : 

"  Since  these  points  have  often  been  and  still  con- 
tinue to  be  disputed  with  great  warmth,  by  physi- 
cians, in  large  volumes,  it  is  proper  to  add  some 
reflections  that  may  seem  to  come  the  nearest  to  the 
truth,  and  which  neither  slavishly  follow  either  of 
these  opinions,  nor  are  too  remote  from  both,  but, 
as   it  were,  intermediate    between  these   opposite 
extremes;    which   those  who   inquire  after   truth 
without  partiality,  may  find  to  be  the  surest  method 
for  directing  the  judgment  in  most  warm  controver- 
sies, as  well  as  in  this  now  before  us.     For,  with 
regard  to  the  causes  of  health  or  disease,  in  what 
manner  the  air  or  food  is  either  conveyed  or  dis  tri- 
buted,  the  philosophers  themselves  do  not  attain  to 
an  absolute  certainty ;   they  only  make  probable 
conjectures.     Now,  when  there  is  no  certain  knowl- 
edge of  a  thing,  a  mere  opinion  about  it  cannot  dis- 
cover a  sure  remedy.     And  it  must  be  owned  that 
nothing   is  of  greater   use,  even    to    the   rational 
method   of    curing,  than    experience.      Although, 
then,  many  things  are  taken  into  the  study  of  arts, 


116 


r>iscouriSE 


which  do  not,  properly  speaking,  belong  to  the  arts 
themselves,  yet  they  may  greatly  improve  them  by 
quickening  the  genius  of  the  artist ;  wherefore  the 
contemplation  of  nature,  though  it  cannot  make  a 
man  a  physician,  yet  may  render  him  fitter  for  the 
practice  of  medicine.  *  *  And  medicine  itself  re- 
quires the  help  of  reason,  if  not  always  amongst  the 
occult  causes  or  the  natural  actions,  yet  often,  for  it 
is  a  conjectural  art ;  and  not  only  conjecture  in  many 
cases,  but  even  experience  is  found  not  consistent 
with  its  rules.  "^  *  A  new  distemper  sometimes, 
though  very  seldom,  appears ;  that  such  a  case  never 
happens,  is  manifestly  false.  ^  *  Nor  is  similitude 
always  serviceable  in  this  kind  of  practice ;  and 
where  it  is,  this  properly  belongs  to  the  rational 
part."  *  *  To  the  physician,  he  adds,  "  it  makes 
considerable  difference  whether  the  distemper  is  oc- 
casioned by  fatigue,  or  thirst,  or  cold,  or  heat,  or 
watching,  or  hunger  ;  or  whether  it  arises  from  too 
much  food  or  wine,  or  excess  of  venery.  And  he 
ought  not  to  be  ignorant  of  the  constitution  of  the 
patient, — whether  his  body  be  too  moist  or  too  dry ; 
whether  his  nerves  be  strong  or  weak ;  whether  he 
be  frequently  or  seldom  ailing ;  and  whether  his  ill- 
nesses are  severe  or  slight,  of  long  continuance  or 
short;  what  kind  of  life  he  has  led,  laborious  or 
sedentary,  luxurious  or  frugal ;  for  from  these  and 
such-like  circumstances,  he  must  often  draw  a  new 
method  of  cure."  ',    •". 

In  reference  to  the  Methodists,  his  censure  is  less 
guarded.  "If  they  assert  their  maxims,"  says  he, 
"to  hold  universally,  they  are  still  more  rationalists 


DISCOURSE.  117 

than  those  who  pass  under  that  name ;  but  if,  which 
is  nearer  the  truth,  the  art  of  medicine  hardly  ad- 
mits of  any  universal  precepts,  then  they  are  in  the 
same  class  with  those  who  depend  upon  experience 
alone.  ^  *  Nor  is  any  improvement  made  by  them 
upon  fche  profession  of  the  empirics ;    but,  on  the 
contrary,  something  is  taken  fix)m  it, — the  empirics 
attending  with  great  circumspection,  to  many  cir- 
cumstances, whereas  these  regard  only  the  easiest, 
and  no  more  than  the  common  things."    ^'    ^'    *    "I 
am  apt  to  think,"  says  he,  "that  he  who  is  not  ac- 
quainted with  the  peculiarities,  ought  only  to  con- 
sider the  general ;  and  that  he  who  can  find  out  the 
particular,  ought  not  to  neglect  but  to  take  them  in 
too,  for  the  direction  of  his  practice.     And  there- 
fore where  knowledge  is  equal,  yet  a  friend  is    a 
more  useful  physician  than  a  stranger.     To  return 
to  my  point,  then,  my  opinion  is,  that  medicine 
ought  to  be  rational ;  but  to  draw  its  methods  from 
the  evident  causes,  all  the  obscure  being  removed, 
not  from  the  attention  of  the  artist,  but  from  the 
practice  of  the  art.     Again,  to  dissect  the  bodies  of 
living  men  is  both  cruel  and  superfluous.     But  the 
dissection  of  dead  subjects  is  necessary  for  learners, 
for  they  ought  to  know  the  position  and  order  of 
the  parts,  which  dead  bodies  will  show  better  than 
a  living  and  wounded  man.     But  as  for  the  other 
things  which  can  only  be  observed  in  living  bodies, 
practice  itself  will  discover  them  in  the  cure  of  the 
wounded,  somewhat   more  slowly,  but  with  more 
tenderness." 

As  a  comment  on  these  remarks,  we  might  refer 


118  DISCOURSE. 

to  his  brief  anatomical  description  of  the  internal 
organs,  at  the  commencement  of  the  fourth  book, 
portions  of  which  could  have  been  derived  only 
from  the  actual  dissection  of  the  human  subject. 

It  has  been  remarked  by  a  recent  critic,  that  Cel- 
sus  paid  little  regard  to  the  pulse  as  an  index  of  the 
condition  of  the  system.  But  his  remarks  on  the 
variability  of  the  pulse  are  perfectly  just,  and  are 
intended  not  to  show  his  neglect  of  it,  but  rather  to 
put  the  physician  upon  his  guard  against  hasty 
judgments.  "  It  is  the  business  of  the  skillful  phy- 
sician," says  he,  "  not  to  take  hold  of  the  patient's 
arm  with  his  hand  as  soon  as  he  comes  in,  but  first 
to  sit  down  with  a  cheerful  countenance,  and  ask 
him  how  he  does  ;  and  if  he  has  any  apprehension, 
to  encourage  him  with  plausible  discourse,  then  to 
apply  the  hand  to  the  w^rist." 

In  common  with  the  elder  Greeks,  he  recom- 
mends caution  in  undertaking  the  management  of 
dangerous  and  incurable  ailments.  "  A  physician," 
says  he,  "  should,  above  all  things,  know  what  are  in- 
curable, what  difficult  to  cure,  and  what  more  easy ; 
for  it  is  the  part  of  a  prudent  man  first,  not  to  un- 
dertake one  whose  case  is  desperate,  lest  he  appear 
to  have  killed  him  whom  destiny  has  destroyed. 
Next,  in  a  case  of  great  danger,  but  not  quite  des- 
perate, to  make  known  to  the  friends  of  the  patient 
that  it  is  a  matter  of  difficulty,  so  that  if  the  mal- 
ady should  prevail  against  the  art,  he  may  neither 
seem  to  have  been  ignorant  himself,  nor  to  have  de- 
ceived them.  But,"  adds  he,  "  as  this  is  the  proper 
conduct  for  a  prudent  person,  so,  on  the  contrary,  it 


DISCOURSE.  119 

is  the  part  of  a  quack  to  exaggerate  a  small  matter, 
that  he  may  appear  to  have  performed  the  greater 
cure."  When  the  case  is  easy,  he  recommends  dili- 
gence and  circumspection  on  the  part  of  the  physi- 
cian, "  that  what  is  in  itself  small,  may  not,  by  his 
negligence,  become  more  considerable.'^ 

Before  leaving  this  able  author,  we  may  notice  his 
opinion  of  what  a  surgeon  should  be,  and  of  what 
surgery  should  embrace.    "  Surgery,  the  third  part  of 
medicine,"  says  he,  "  does  not  discard  medicines  and 
proper  regimen ;  but  yet  the  principal  part  is  ac- 
complished by  the  hand,  and  the  effect  of  this  is 
the  most  evident  of  all  the  parts  of  medicine.     For, 
as  fortune  contributes  a  good  deal  to  the  cure  of  dis- 
tempers, and  the  same^ things  are  often  salutary, 
often  fruitless  ;  it  may  be  doubted  whether  the  re- 
covery be  owing  to  physic  or  the  constitution.    *    * 
But   in    surgery,   it    is   manifest  that  the  success, 
though   it  may  be  somewhat   promoted  by    other 
means,  is  chiefly  to  be  ascribed  to  this."     "  A  sur- 
geon,"  he   continues,    "  ought   to  be   young,  or  at 
most,  but  middle-aged ;  to  have  a  strong  and  steady 
hand,  never  subject  to  tremble,  and  to  be  no  less 
dexterous  with  his  left  than  his  right  hand  ;  to  have 
a  quick  and  clear   sight;  to  be  bold,  and  so  far 
void  of  pity  that  he  may  have  only  in  view  the  cure 
of  him  whom  he  has  taken  in  hand,  and  not  in  com- 
passion to  his   cries  either  make  more  haste  than 
the  case  requires,  or  cut  less  than  is  necessary ;  but 
do  all  as  if  he  were  not  moved  by  the  shrieks  of 
the  patient."     And  then,  as  to  the  province  of  sur- 
gery, "  it  may  be  asked  what  peculiarly  belongs  to 


m 


120  T)ISCOURSE. 

this  branch,  because  surgeons  assume  to  themselves 
the  curing  of  many  wounds  and  ulcers  which  I  have 
treated  of  elsewherie,  I  can  very  well  suppose  the 
same  person  capable  of  performing  all  these ;  and 
since  they  are  divided,  I  esteem  him  most  whose 
skill  is  most  extensive.  For  my  part,  I  have  left  to 
this  branch  those  cases  in  which  the  physician  makes 
a  wound  where  he  does  not  find  one;  and  those 
wounds  and  ulcers,  in  which  I  believe  manual  oper- 
ation to  be  more  useful  than  medicine ;  lastly, 
whatever  relates  to  the  bones." 

It  would  here  be  out  of  place  to  enter  further  into  a 
notice  of  the  individual  diseases  of  which  he  treats  in 
the  several  divisions  of  his  work.  I  may,  however, 
mention,  as  particularly  worthy  of  perusal,  his  chap- 
ters on  diet  and  regimen,  on  blood-letting,  on  fevers, 
on  poison-wounds,  on  the  extraction  of  weapons 
from  the  body,  on  the  diseases  of  the  eye  ;  his  de- 
scription of  ranula  and  his  mode  of  treating  it ; 
the  chapter  on  diseases  of  the  testicles  and  parts 
contiguous,  including  hernia,  and  the  operations  for 
these ;  and  above  all,  his  chapter  on  the  operations 
for  suppression  of  urine,  and  for  lithotomy.  In  this 
we  find  all  the  necessary  details  for  catheterism  as 
still  employed ;  and  the  Eoman  method  of  operating 
for  stone  by  the  transverse  semilunar  incision 
in  the  perineum,  with  the  horns  of  the  incision 
pointing  towards  the  hips,  as  lately  revived  by 
Dupuytren  and  other  modern  surgeons. 

In  the  management  of  wounds  he  advocates  the 
use  of  sijuple  and  familiar,  in  preference  to  rare  and 
expensive  remedies,  or  the  heterogeneous  composi- 


DISCOURSE.  121 

tions  so  mucli  in  vogue  among  the  Komans.  He 
was  aware  that  certain  poisons,  though  deleterious 
when  received  into  wounds,  are  innocuous  when 
taken  into  the  mouth.  In  the  treatment  of  wounds 
thus  poisoned,  he  recommends  suction  for  the  ex- 
traction of  the  poison.  He  applies  the  ligature  to 
divided  or  lacerated  blood-vessels  ;  he  employs  this 
same  agent  for  the  cure  of  varices,  and  for  checking 
the  loss  of  blood  from  haemorrhoids.  He  enters 
somewhat  fully  into  the  pathology  of  injuries  of  the 
head ;  and,  when  indicated,  employs  the  trephine 
and  other  proper  means  for  the  cure  of  such  acci- 
dents. He  enters  more  minutely  into  the  consider- 
ation of  injuries  at  the  hip,  than  many  of  the  early 
surgical  writers  of  modern  times ;  but  in  common 
with  most  of  his  predecessors,  he  fails  to  distinguish 
between  fractures  of  the  neck  of  the  femur  and  dis- 
locations at  the  hip  joint. 

Among  the  Latin  writers  practicing  at  Kome  at 
this  period,  were  Apuleius  Celsus,  and  his  pupil 
Scribonius  Largus,  the  first  probably  somewhat  the 
senior  and  the  other  the  junior  of  Cornelius  Celsus. 

Apuleius  was  a  native  of  Centuripa,  in  Sicily. 
He  was  long  in  high  and  deserved  repute  at  Rome, 
where  he  was  engaged  in  teaching,  as  well  as  prac- 
ticing. Among  his  pupils  was  Vectius  Valens, 
celebrated  afterwards  for  his  intrigue  with  Messa- 
lina,  the  wife  of  Claudius.*  The  works  of  Apuleius 
have  mostly  perished,  though  there  is  still  extant  a 


*  Pliny,  Hist.  Nat.,  lib.  xxix.  cap.  v. 

9 


122  DISCOURSE. 

treatise  on  the  virtues  of  herbs,*  which  has  some- 
times been  ascribed  to  Apuleius  Madaurensis,  the 
author  of  the  Golden  Ass ;  but  which  those  who 
have  examined  it  with  greatest  care,  attribute  to 
Apuleius  Celsus.  The  author  of  this  treatise,  De 
Medicaminibus  Herbarum,  states  in  his  preface,  that 
it  was  prepared  for  the  benefit  of  the  public,  and  to 
relieve  the  common  reader  from  the  verbose  stupid- 
ity of  the  profession,  the  greater  part  of  whom  he 
characterizes  as  ignorant  pretenders,  more  intent  on 
the  acquisition  of  wealth  than  on  the  cure  of  the 
sick.  Much  of  the  work  is  occupied  with  anti- 
dotes, and  specifics  against  the  bites  and  stings  of 
venomous  animals.  It  is  proper  to  remark  that 
some  recent  and  able  critics  have  questioned  the 
authenticity  of  this  work,  and  ascribed  it  to  some 
unknown  writer  of  the  middle  ages. 

Scribonius  Largus,  who  flourished  during  the 
reign  of  Claudius,  and  accompanied  this  emperor  in 
his  expedition  into  Britain,  was  an  incorrect  writer 
of  the  Latin  tongue,  but  in  a  professional  point  of 
view,  an  author  of  considerable  merit.  Though  an 
admirer  of  Asclepiades,  he  appears  to  have  written 
in  the  spirit  of  empiricism.  His  treatise,  De  Com- 
positione  Medicamentorum,f  is  devoted  rather  to 
the  composition  and  uses  of  medicines,  than  to  the 
consideration  of  the  diseases  to  which  these  are  ap- 
plied. Many  of  his  compound  confections  are 
quoted  by  later  writers.     He  abounds  in  remedies 

*  Already  mentioned  in  connection  with  the  work  of  Antonius  Musa, 
published  at  Bale,  1536. 

f  See  the  "  Medicinae  Artis  Principes,"  foL,  Venitiis,  1567. 


DISOOUESE.  123 

for  the  cure  of  particular  ailments;  and,  as  usual, 
his  antidotes,  theriacse,  plasters,  and  embrocations, 
are  highly  illustrative  of  the  polypharmacy  of  his 
times.  He  gives  the  formula  for  the  celebrated 
mithridaticum,  an  antidote  against  all  kinds  of 
poisons,  said  to  have  been  invented  or  employed  by 
Mithridates,  king  of  Pontus ;  but  which,  as  here 
given,  differs  materially  as  well  from  the  formula 
said  to  have  been  discovered  by  Pompey  among  the 
archives  of  Mithridates,  as  from  that  which  we  find 
in  Galen."^  How  far  this  work  of  Scribonius  Largus 
was  original,  and  how  far  derived  from  other  writers, 
we  are  not  able  to  determine.  By  some  critics  it 
is  said  to  have  been  little  else  than  a  translation 
from  Nicander ;  but  careful  perusal  will  show  that 
portions  of  it,  at  least,  could  not  have  been  from 
that  early  source.  The  writer  himself  expressly 
informs  us  that  the  greater  part  of  his  composi- 
tions he  had  himself  prepared  and  used,  and  that 
the  rest  were  mostly  obtained  from  his  friends. 
Among  these  friends  must  have  been  Apuleius,  his 
preceptor,  whose  writings  he  may  have  appropriated 
with  considerable  freedom.  For  Marcellus  Empiri- 
cus,  who  makes  no  allusion  to  this  work,  and  ac- 
knowledges that  he  himself  has  copied  from  Apu- 
leius, gives  numerous  passages  which  are  also  found 
almost  word  for  word  in  the  writings  of  Scribonius. 
Again,  this  author  has  been  charged  with  recom- 


*  The  Mithridaticum,  according  to  Pliny,  was  a  composition  for  the  lux- 
urious who  could  afford  to  pay  for  it,  consisting  of  fifty-four  different  in- 
gredients derived  from  abroad,  and  used  where  simple  domestic  remedies 
would  have  answered  as  well.     See  Hist.  Nat.  xxix.  8. 


124:  DISCOUKSE. 

mending  his  medicaments  indiscriminately ;  but 
he  himself  declares  that,  in  the  diseases  for  which 
they  are  intended,  they  will  sometimes  prove  bene- 
ficial and  sometimes  fail,  according  to  the  condition 
or  age  of  the  patient,  the  season  of  the  year,  pe- 
culiarities of  time  and  place,  or  other  varying  cir- 
cumstances ;  and  that  even  in  bodies  to  all  appear- 
ance similarly  situated,  the  same  agent  will  not 
always  produce  the  same  effects. 

About  this  same  epoch  also  flourished  Athenseus, 
a  native  of  Attaleia,  in  Asia  Minor,  who,  while 
practicing  and  teaching  at  Rome,  took  strong  ground 
against  the  Methodists,  and  became  the  founder  of 
the  Pneumatic  sect.*^  He  is  generally  supposed  to 
have  written  subsequent  to  the  time  of  Cornelius 
Celsus,  inasmuch  as  the  latter  makes  no  direct  allu- 
sion to  him.  But  the  doctrines  of  this  fourth  sect 
were  essentially  the  same  as  those  promulgated  by 
Erasistratus,  in  reference  to  th,e  Pneuma,  or  spirit, 
as  a  fifth  element ;  the  disturbance  of  which  in  the  liv- 
ing body  was  assumed  to  be  the  essential  cause  of  all 
diseases.  Now,  to  this  doctrine  Celsus  does  allude, 
and  even  devotes  a  section  in  strenuous  opposition 
to  it,  referring  to  Erasistratus  as  its  author.  The 
doctrine  of  a  fifth  element,  however,  was  even 
more  ancient  than  this  writer.  The  term  Pneuma 
was  employed  by  Aristotle ;  and  the  ^ve  elements 
are  distinctly  enumerated  in  the  "  Epinomis,"  a  dia- 
logue which  on  good  authority,  is  ascribed  to  Plato, 

*  See  Galen,  Kuhn's  edition,  vol.  vii.  609,  viii.  749,  xix.  34*7,  356.  He 
should  not  be  confounded  with  Athenaeus  of  Naucratis,  who  flourished  in 
the  third  century. 


DISCOURSE.  125 

or  at  latest,  to  his  pupil,  Philip  of  Opuntium  *  As 
there  are  ^ve  bodies,  observes  the  author  of  this  dia- 
logue, it  is  requisite  to  say  that  fire  is  the  first, 
water  the  second,  air  the  third,  earth  the  fourth, 
and  aether  the  fifth;  and  that  in  the  domains  of 
each  of  these  is  produced  many  an  animal,  and  of 
every  kind.f 

Athenseus,  then,  owed  his  reputation  more  to  his 
attack  upon  the  Methodists  than  to  the  modifica- 
tions of  Rationalism  which  he  adopted.  His  own 
peculiar  opinions  were  of  only  temporary  notoriety. 
Agathinus  of  Lacedsemonia,  who  had  been  among 
his  followers,  undertook  to  reconcile  the  doctrines  of 
his  master  with  those  of  the  other  sects,  and  thus 
became  the  founder  of  the  Episynthetics,  or  Ec- 
lectics.J 


Section  II. — The  later  Methodists  of  the  Romcm  School. 

Among  the  writers  of  the  Roman  school,  it  is  not 
always  easy  to  distinguish  those  who  were  of  Gre- 
cian birth,  from  those  of  Roman  origin.  As  early 
as  the  reign  of  Augustus,  the  Greek  became  the  ac- 
cepted language  of  the  court  ;§  and  it  had  always 
been  the  language  of  the  schools,  and  of  science. 
Among  the  early  Roman  Medical  writers  forsak- 


*  Plato  (Kuhn's  edition),  vol.  vi.  p.  195.  f  Ibid.  vol.  vi.  p.  17. 

X  Galen,  vol.  xix.  353.  §  Suetonius,  in  Life  of  Augustus. 


126  DISCOTRSE. 

ing  their  native  language,  were  Sextus  Niger  and 
Julius  Bassus,  who  are  referred  to  by  Pliny  and 
others,  but  of  whose  writings  we  have  no  remains. 
They  were  both  of  the  Methodic  sect,  as  were  also 
most  of  the  practitioners  at  Rome  between  the 
reign  of  Augustus  and  that  of  Marcus  Aurelius ;  of 
whom,  besides  those  already  mentioned,  were  the 
Greek  physicians  Andromachus,  Thessalus,  Philo- 
menus,  Archigenes,  Heliodorus,  Antyllus,  and  So- 
ranus. 

Andromachus  the  elder,  was  of  Crete,  and  a  pupil 
of  Diogenes  of  Babylon*  He  was  physician  to  the 
emperor  Nero,  and  the  first  to  enjoy  the  official  dis- 
tinction of  Archiater,  a  title  to  which  we  shall  have 
occasion  to  return.  He  was  celebrated  for  his  the- 
riaca,  into  which  he  introduced  the  flesh  of  vipers, 
to  which,  at  that  time,  were  ascribed  wonderful 
effects  as  an  antidote. 

Thessalus  was  a  native  of  Tralles,  in  Lydia,  and 
is  spoken  of  by  Plinyf  and  Galen,  as  a  charlatan. 
He  was  a  man  of  low  origin,  vulgar  manners,  and 
supercilious  spirit.  Though  of  the  Methodic  sect, 
he  had  too  little  regard  for  the  opinions  of  others  to 
be  the  strict  follower  of  any  theorist.  With  little 
knowledge  of  the  literature  of  medicine,  he  held 
himself  superior  to  all  his  predecessors,  and  boasted 
of  being  able  to  impart  the  whole  art  to  his  pupils 
in  the  space  of  six  months.  He  flourished  at  Rome 
during  the  reign  of  Nero,  and  by  his  practice  ac- 
cumulated immense  wealth.     He  was  the  author  of 

*  Galen,  in  numerous  passages.         f  Hist  Nat.  lib.  xxix.  cap.  v. 


DISC0UK8E.  127 

several  works,  all  of  which  have  perished.  Caelius 
Aurelianus  attributes  to  him  a  treatise,  in  several 
books,  on  Dietetics ;  and  another,  also  in  several 
books,  entitled  "  Comparatio." 

Philomenus,  another  writer  of  the  Methodic  sect, 
flourished  about  this  same  epoch,  and  is  occasion- 
ally quoted  by  Oribasius,  Aetius,  and  Alexander 
Trallianus.  He  pointed  out  the  affinity  between 
dysentery  and  the  prevailing  fever  of  the  season. 
He  was  the  first  to  recommend  assafoetida  and  fric- 
tions with  tepid  oil,  for  the  treatment  of  tetanus. 
He  wrote  on  the  diseases  of  women,  and  on  the 
removal  of  the  foetus  by  artificial  means.* 

Archigenes  of  Apamea,  in  Syria,  was  in  great 
repute  at  Rome,  as  a  physician  and  surgeon.  He 
flourished  in  the  reign  of  Trajan.  His  works  were 
numerous,  and  are  often  quoted  with  commendation, 
by  Galen  and  others.  He  wrote  ten  books  on 
fevers,  three  on  local  affections,  also  on  the  use  of 
castor,  and  of  hellebore  in  mentagra  and  other  cu- 
taneous affections ;  and  on  surgical  diseases,  some 
fragments  of  which  are  still  extant  in  the  collections 
of  Nicetas.f  His  description  of  the  operation  of 
amputating,  is  worthy  of  notice.  He  begins  by  re- 
tracting the  integuments  of  the  limb  ;  he  next  applies 
a  circular  compress  or  tourniquet  for  controlling  the 
loss  of  blood;  he  even  recommends,  when  neces- 
sary, a  preliminary  operation  for  securing  the  blood- 
vessels and  stitching  them,  before  proceeding  to  the 

*  See  Sprengel,  tome  ii.  p.  31. 

f  GrjBcorum  Chirurgici  libri,  e  collectione  Nicetse,  eonversi  et  editi  ab 
Antonio  Cocchio.    Flore  ntiie,  fol.  1754:,  p.  118  and  164. 


128  DISCOURSE. 

amputation.  Tliis  he  performs  invariably  at  tlie 
joint,  by  a  circular  incision.  After  tbe  removal  of 
the  limb,  whatever  haemorrhage  occurs  he  arrests  by 
the  actual  cautery  ;  taking  due  care  not  to  apply 
the  heated  iron  to  the  divided  extremities  of 
nerves. 

Heliodorus  is  also  more  particularly  noted  as  a 
surgeon.  Fragments  of  his  writings  on  wounds  of 
the  head,  on  fractures  of  the  skull,  and  other  in- 
juries, may  also  be  found  in  Oribasius*  and  the 
collections  of  Nicetas.f  His  remarks  on  injuries  of 
the  skull  are  judicious,  and  indicative  of  a  careful 
observer;  and  his  treatment,  such  as  might  be 
recommended  at  the  present  day.  His  dressings 
are  iight,  his  local  applications  simple,  usually  moist 
compresses,  roseated  oil,  simple  cerate,  and  tepid 
water.  For  controlling  inflammation  he  resorts  to 
low  diet,  and  occasionally  to  venesection.  He  speaks 
of  amputating  in  the  continuity  of  the  long  bones, 
but  looks  upon  operations  above  the  knee  and 
elbow  as  extremely  dangerous,  from  loss  of  blood. 
To  obviate  this  danger  as  far  as  possible  at  other 
points,  he  makes  his  incision  first  through  those 
parts  of  the  limb  in  which  the  bones  are  most 
superficial ;  he  next  saws  through  the  bones ;  and 
he  reserves  his  incision  through  the  fleshy  part  of 
the  limb,  where  the  vessels  are  most  numerous,  to 
the  last. 

Antyllus,  another  surgeon,  though  not  mentioned 


*  Collect,  lib,  viii.  chap.  3,  4,  and  elsewhere, 
f  Page  90  to  105.     pp.  124,  156. 


DISCOURSE.  120 

by  Galen,  is  by  some  writers  presumed  to  have  pre- 
ceded him,  whilst  by  others  he  is  placed  as  late  as  the 
reign  of  Valerian.  He  is  frequently  mentioned  by 
the  later  Greeks.  In  the  collections  of  Nicetas*  is  a 
fragment  of  his  on  elastic  or  watery  tumors  of  the 
head,  superficial  and  deep-seated ;  including  among 
the  last,  congenital  or  chronic  hydrocephalus. 
The  superficial  varieties  he  encounters  with  fair 
hope  of  success,  but  with  those  more  deeply  seated 
he  is  indisposed  to  interfere.  He  treated  humid 
asthma  with  suffumigations,  placing  the  patient  in 
such  a  position  as  readily  to  inhale  the  fumes  from 
particles  of  aristolochia  or  clematis  previously 
sprinkled  over  burning  coals  in  a  chaffing-dish  or 
brasier.f  He  operated  on  cataract  by  extraction  ; 
with  Asclepiades,  he  recommends  tracheotomy  in 
threatened  suffocation;  and  he  treated  hydrocele 
by  incision.J 

Soranus  of  Ephesus,  the  second  of  that  name,  was 
educated  in  part  at  least  at  Alexandria,  and  prac- 
ticed with  great  eclat  at  Eome  under  the  reigns  of 
Trajan  and  Adrian.  He  was  celebrated  both  as  a 
teacher  and  practitioner ;  and  is  admitted  to  have 
been  the  ablest  exponent  of  the  Methodic  doctrines, 
which  he  carried  to  their  highest  degree  of  popu- 
larity. He  was  the  first  to  mention  the  Dracun- 
culus  or  Guinea  worm  {vena  medinensis^  Among 
the  fragments  of  his  writings  still  preserved,  we  have 
a  treatise  on  the  female  organs  of  generation,  and 
another  on  fractures,  which  is  contained  in  the  col- 

*  Page  121. 

f  Oribasius,  collect,  lib.  viii.  cap.  12. 

\  Sprengel,  tome  ii.  p.  94,  from  Rhazes  and  PanluES;. 


130  DISCOURSE. 

lections  of  Nicetas,  and  is  mostly  made  up  of  defi- 
nitions. This  second  Soranus  is  not  to  be  con- 
founded with  still  another  of  the  same  name,  also  of 
Ephesus,  a  writer  of  later  date,  and  the  reputed 
author  of  a  memoir  on  the  life  of  Hippocrates. 
The  works  of  the  second  Soranus,  though  mostly 
lost,  served  as  the  model  for  those  of  Cselius  Aureli- 
anus,  who  is  supposed  to  have  embodied  the  greater 
part  of  them  in  a  translation.  To  him,  therefore, 
we  must  next  direct  our  attention.* 

Caelius  Aurelianus,  sometimes  called  Lucius  Caelius 
Arianus,  was  a  native  of  Sicca  in  Numidia.  He 
appears  to  have  been  a  voluminous  writer-  Besides 
his  work  on  Acute  and  Chronic  Diseases,  which  is 
preserved  entire,f  he  was  the  author  of  Greek 
Epistles  addressed  to  Prsetextatus ;  of  a  work  on 
Fevers,  and  of  another  on  Diseases  of  Females ;  of 
distinct  treatises  on  the  Causes  of  Disease,  on  Sur- 
gery, on  the  Eules  of  Health,  on  Adjuvants  or  the 
General  Remedies  of  the  Methodic  sect,  and  on. 
Medicaments  ;  besides  several  books  of  Medical  In- 
terrogations and  Responses ;  and  a  book  of  Prob- 
lems ; — all  of  which  have  perished.  His  work  on 
Acute  and  Chronic  Diseases  is  written  in  impure 
Latin ;  and  much  of  it,  as  the  author  admits,  has 
been  borrowed  from  Soranus.  But  it  can  hardly 
be  considered  a  translation,  since  much  of  it  was 
evidently  the  result  of  the  author's  own  observ- 
ation and  experience.      Of  the  eight  books  consti- 


*  Cselius  Aurelianus,  and  Galen  in  several  places, 
f  Caelii  Aureliani  Ciccensis   de  Morbis  Acutis  et  Chronicis  libri  viii. 
4to.     Amstelaedami,  1*722. 


DISCOURSE.  131 

tuting  tills  work,  three  are  devoted  to  the  history 
and  treatment  of  acute,  and  five  to  the  history  and 
treatment  of  chronic  diseases.  The  several  maladies 
are  arranged  in  the  usual  order  from  head  to  foot, 
considered  in  their  relation  to  concomitant  consti- 
tutional disturbances,  and  spoken  of  as  accompanied 
or  not  accompanied  with  fever.  This  valuable 
summary  of  theory  and  practice,  can  scarcely  be 
considered  as  advocating  only  the  doctrines  of  the 
Methodic  sect.  Though  its  author  is  a  favorer  of 
these  doctrines,  he  speaks  as  an  independent  ob- 
server, criticises  the  leading  writers  of  his  own 
party,  and,  in  disposing  of  his  materials,  gives  first 
his  own  proper  opinions  on  the  history  or  pathology 
of  the  disease  in  question,  and  afterwards  those  of  the 
several  leading  writers  of  the  other  sects ;  drawing, 
however,  almost  exclusively  from  the  Greeks,  and 
furnishing  a  systematic  exposition  of  the  theory  and 
practice  of  physic,  both  of  his  own  and  previous 
times.  But  in  referring  to  his  predecessors  he  is 
much  more  solicitous  to  give  their  treatment  than 
their  pathological  opinions ;  which,  however,  he 
does  not  entirely  overlook.  Cselius  Aurelianus, 
quoting  from  Soranus,  is  the  first  writer  in  whom  I 
remember  to  have  met  with  a  practical  distinction 
between  what  he  calls  the  signs  and  the  symptoms  of 
disease,  a  distinction  still  worthy  of  remembrance : 
the  signs  being  always  present  during  the  existence 
of  the  disease  ;  the  symptoms  being  mere  accidents, 
that  may  or  may  not  be  observable,  without  ne- 
cessarily implying  any  essential  modification  in 
the  disease  itself  His  chapters  on  diseases  of  the 
head   are    ably  written,   and   evince   much    prac- 


132  DISCOURSE. 

tical  acquaintance  with  the  subject.  In  his  chap- 
ter on  Cynanche  he  says,  some  forms  of  Cynan- 
che  are  without  visible  manifestations ;  others 
are  visible  and  manifest,  either  within  the  fauces,  or 
externally,  or  both  externally  and  internally,  and 
in  one  or  both  sides.  The  transition  from  this  de- 
scription to  that  of  the  monkish  writers  of  the 
middle  of  the  thirteenth  century,  Roger,  Roland, 
and  the  author  of  the  Four  Masters,  is  curious 
and  amusing.  Thus,  says  Roland,  Squinantia  is  an 
aposthem  of  the  throat,  of  which  there  are  three 
sorts ;  and  hence  the  verse, — 

"  Qui  (nancia)  latet,  squi  (nancia)  patet,  si  (nancia)  manet  intus  et  extra." 

While  on  diseases  of  the  throat,  Caelius  Aurelianus 
takes  occasion  to  criticise  Hippocrates,  particularly 
in  reference  to  the  inhalation  of  vapors  medicated 
with  hyssop,  sulphur,  or  bitumen,  by  means  of  a 
tube  introduced  within  the  fauces,  for  the  relief  of 
threatened  suffocation  ;  a  practice  against  which  he 
speaks  in  the  strongest  terms ;  judging  it  impossible 
to  insert  a  tube  into  the  fauces  already  so  much 
obstructed  as  not  to  admit  even  air, — or  to  inject 
thick  smoke  where  thin  air  is  unable  to  penetrate.* 

As  Soranus  and  Caelius  Aurelianus  are  considered 
the  ablest  exponents  of  the  Methodic  doctrines ; 
and  as  we  learn  from  them  what  would  be  sought 
in  vain  elsewhere  concerning  Asclepiades,  Themi- 
son,  Thessalus,  and  others  of  this  sect,  it  may  be 
proper  here  to  give  a  summary  of  their  practice  at 
the  period  of  its  greatest  eminence. 

They  confined  themselves  as  much  as  possible  to 

*  See  his  works,  p.  191. 


DISCOURSE.  133 

general  remedies ;  to  tlie  exclusion  of  specifics,  or 
particular  remedies  for  particular  ailments.  In  tlie 
management  of  disease  their  first  care  was  tliat  the 
chamber  of  the  patient,  the  air  surrounding  him, 
and  the  arrangements  of  his  bedding,  should  be  well 
selected.  Food  and  drink  were  allowed  in  modera- 
tion, provided  the  circumstances  of  the  case  did  not 
clearly  prohibit  these.  Under  this  course  the  tend- , 
encies  of  the  disease  were  for  some  days  sedulously 
watched.  A  generous  or  supporting  diet  was  rarely 
employed  within  the  first  three  days,  during  which, 
time  they  watched  for  the  concoction  of  such  cru- 
dities as  might  have  existed  in  the  primae  vise  ;  and 
partly  by  abstinence,  partly  by  friction,  fomenta- 
tion, and  inunction,  they  looked  for  the  removal  of 
these.  During  the  second  period  of  three  days, 
unless  the  urgency  of  the  case  called  for  greater 
expedition,  they  employed  venesection  when  indica- 
ted ;  or  cupping,  if  necessary,  over  every  part  of  the 
body ;  sometimes  with  scarification,  sometimes  dry, 
and  sometimes  in  connection  with  leeches.  Among 
their  general  remedies  for  resolving  constriction 
were,  warm  and  sunny  air,  a  soft  couch,  gargarisms 
of  tepid  water  or  of  fresh  and  fragrant  oil,  fasting, 
watching,  inunction,  emollient  cataplasms,  fomen- 
tations and  baths,  humid  cupping,  venesection,  ges- 
tation, and  passive  motion  generally,  emollient 
clysters,  and  emetics.  For  astringing  the  body, 
already  too  much  relaxed,  they  employed  cold  air, 
a  shaded  position,  a  hard  couch,  gargarism  of  vine- 
gar and  water,  or  vinegar  and  posca  (dilute  aro- 
matic wine)    applied   with  a  sponge,  cold  lotions 


134:  DISCOURSE. 

containing  the  juice  of  plantain,  of  portulaca,  or 
sempervirens ;  a  diet  of  barley  meal,  of  lentils,  or  of 
quinces,  or  toasted  bread  moistened  with  vinegar, 
sound  sleep,  repose,  dry-cupping.  They  rarely  re- 
sorted to  purgatives  except  in  dropsies;  they  were 
equally  opposed  to  diuretics  and  sudorifics,  to  irri- 
tating clysters,  to  opiates,  and  to  the  abstraction  of 
blood  from  the  sublingual  vessels,  as  others  had 
recommended,  ad  deliquium  miimi,  Nor  would 
they  resort  to  measures  likely  to  jeopardize  the 
safety  of  their  patient.  In  the  treatment  of  tumors, 
a  term  applied  by  them  to  all  inflammatory  swell- 
ings, while  the  disease  was  on  the  increase,  they 
employed  moderate  astringents;  when  stationary, 
relaxing  and  assuaging  remedies ;  when  on  the  de- 
cline, emollients.  In  diseases  attended  with  distinct 
remissions  or  intermissions,  particularly  with  regu- 
larly recurring  paroxysms,  they  employed  recuper- 
atives^  called  also  metasyncratica^  by  which  they 
meant  fortifying  and  analeptic  agents ;  among  which 
were  included  violent  exercises,  hoping  thereby  to 
expel  from  the  body  while  relaxed,  the  worn-out  or 
diseased  flesh,  and  to  replace  this  by  new  and 
healthy  tissues.  For  checking  profuse  sweating, 
they  sprinkled  the  surface  of  the  body  with  pow- 
dered chalk  or  alum,  and  with  various  other 
astringents. 

The  obstetric  art  among  the  ancients  was  usually 
in  the  hands  of  illiterate  females,  who  acquired  their 
information  by  experience.  But  for  the  instruction 
of  the  better  sort  of  them,  as  well  as  of  the  matrons 
who  had  occasion  for  their  services,  several  works 


DISCOUKSE.  135 

appear  to  have  been  in  use,  among  which  was  a 
treatise  by  Aspasia,  now  lost,  but  of  which  mention 
is  made  by  Aetius ;  and  the  essay,  in  one  hundred 
and  fifty-two  short  chapters,  by  Moschion,  also 
mentioned  by  the  same  author;  a  work  which  is 
still  extant.  Moschion  appears  to  have  flourished 
at  Rome  soon  after  Soranus  or  Cselius  Aurelianus. 
In  the  preface  to  his  work  on  the  Diseases  of  Wo- 
men,* he  tells  us  it  was  intended  for  the  benefit  of 
mothers,  and  of  those  females  who  were  devoted  to 
the  obstetric  art,  and  familiar  only  with  the  Latin 
tongue.  It  must,  therefore,  have  been  originally 
written  in  Latin  ;  but  we  have  only  now  remaining 
the  Greek  version,  which  was  probably  made  long 
after  the  original  work  had  first  appeared.  The 
author  acknowledges  that  he  had  drawn  most  of 
his  materials  from  earlier  Greek  writers,  but  with 
corrections  and  additions,  for  which  we  are  indebted 
to  himself  He  is  usually  spoken  of  as  belonging 
to  the  Methodic  sect.  But  he  is  bound  to  no 
theory ;  he  reasons  and  prescribes  according  to  the 
exigencies  of  each  case,  usually  with  much  skill  and 
judgment.  He  goes  over  the  whole  subject  of  ob- 
stetrics, the  diseases  of  the  puerperal  woman,  and 
the  management  of  the  infant ;  he  enters  into  the 
requirements  of  the  sick  room,  the  qualifications  of 
an  accomplished  obstetrix,  and  those  of  a  good 
nurse,  the  diet  and  exercise  for  the  nursing  woman, 
and  the  training  proper  for  the  child.  He  intro- 
duces many  acute  and  discriminating  remarks  in 

*  Moschionis  de  Mulierum  Pa ssionibiis liber.  12mo.  Viennse,  1793,   Other 
works  of  this  author  are  also  still  extant. 


136  DISCOURSE. 

connection  with  these  subjects ;  as  also  in  his  chap- 
ters on  suppression  of  the  menses,  inflammation  of 
the  uterus,  hysteria,  uterine  haemorrhage,  fluor  albus, 
displacements  of  the  uterus,  and  the  symptoms  indi- 
cative of  these.  The  work,  in  some  of  the  editions 
still  extant,  has  been  subjected  to  objectionable 
interpolations;  omitting  which,  it  is  worthy  of 
the  attention  even  of  the  modern  practitioner. 

The  culinary  art  among  the  Eomans  was  too  inti- 
mately related  to  that  of  the  apothecary,  and  had 
too  close  a  bearing  upon  the  practice  of  medicine,  to 
be  passed  over  in  silence.  Their  principal  writer  in 
that  department,  Apicius  Coelius,  by  birth  a  Span- 
iard, and  according  to  Athenseus,*  very  rich  and  luxr 
urious,  living  chiefly  at  Minturnae,  in  Campania, 
flourished  during  the  reign  of  Trajan ;  and  many  of 
his  preparations  were  as  useful  in  the  chamber  of 
sickness  as  they  were  acceptable  at  the  banquet. 
Among  these  might  be  noticed  his  aromatic  wines, 
perfumed  with  the  rose,  the  violet,  and  other  fra- 
grant flowers,  in  nearly  the  same  manner  as  the  an- 
cient apothecaries  prepared  their  aromatic  oils.  His 
formula  for  preserving  grapes  fresh  throughout  the 
year  for  the  benefit  of  the  sick,  and  his  mode  of 
preserving  apples,  pears,  quinces,  cherries,  plums, 
and  other  fruits,  are  equally  worthy  of  attention. 
His  treatise  is  a  work  of  much  more  pretension  than 
most  of  our  modern  works  on  the  art  of  cookiog.f 

It  is  divided  into  ten  books,  in  which  are  dis- 

*  Deipnosophists,  book  i.  c.  xii. 

f  Apicii  Coelii  de  Opsoniis  et  Condimentis,  sive  Arte  Coquinaria,  libri 
decern,  12mo.  Amstelodami,  1709. 


DISCOURSE.  137 

played  the  various  mysteries  of  Greek  and  Roman 
luxury  under  the  head  of, — 1st,  Epimeles,  or  condi- 
ments and  confections ;  2d,  Sarcoptes,  or  made 
dishes,  mostly  of  animal  food ;  3d,  Cepuros,  or 
Hortulanus,  referring  to  vegetables,  pickles,  and  car- 
minatives ;  4th,  Pandecter,  mostly  prepared  vegetable 
dishes ;  5th,  Osprios,  leguminous  and  pultaceous 
preparations;  6th,  Aeropetes,  or  dishes  prepared 
from  birds  of  every  kind ;  7th,  Politeles,  sumptuous 
preparations  mostly  of  animal  substances;  8th, 
Tetrapus,  or  dishes  from  the  flesh  of  quadrupeds ; 
9th,  Thalassa,  dishes  from  sea-fish,  shell-fish,  and  the 
like  ;  and  10th,  Halieus,  or  dishes  of  fish  procured 
by  the  angler. 

From  the  Deipnosophists  of  Athenaeus,*  a  junior 
contemporary  of  Galen,  much,  also,  may  be  learned 
of  the  luxurious  habits  of  the  Romans, 


Section  III. — Pliny  the  Elder, 

We  have  next  to  notice  a  Latin  writer  who, 
though  not  a  physician,  gave  much  attention  to 
medical  studies ;  and,  as  a  compiler,  has  materially 
contributed  to  our  knowledge  of  the  profession 
among  the  ancients.  I  allude  to  Pliny  the  natural- 
ist, or  the  elder,  as  he  is  often  called,  to  distinguish 
him  from  his  nephew.  He  was  born  at  Verona, 
A.  D.  23,  during  the  reign  of  Tiberius,  and  received 

*  In  3  vols.,  London,  1854. 

10 


138  DISCOURSE. 

some  portioQ  of  his  early  education  in  attendance 
upon  tlie  lectures  of  Appion  at  Rome.  He  was  oc- 
cupied, during  the  greater  portion  of  his  life,  in  the 
service  of  the  state,  in  civil  offices  among  the  pro- 
vinces, and  in  military  enterprises  in  Germany  and 
elsewhere,  under  Vespasian,  who  was  attached  to 
him  as  an  intimate  friend,  and  under  Titus  in  Pales- 
tine. But  notwithstanding  the  number  and  import- 
ance of  his  public  duties,  he  found  leisure  for  exten- 
sive reading,  and  for  the  exercise  of  his  talents  as  a 
writer.  He  was  the  author  of  numerous  works  on 
history,  on  military  affairs,  and  other  subjects;  but 
all  that  now  remains  of  these  is  his  Natural  History, 
the  last  of  his  literary  performances,  compiled, 
A.  D.  78,  only  two  years  before  his  death.  He 
perished  by  suffocation,  from  venturing  too  near  to 
Mount  Vesuvius  while  in  a  state  of  active  eruption. 
This  work  of  Pliny*  is  not  merely  a  natural  his- 
tory in  the  present  restricted  meaning  of  the  ex- 
pression, but,  as  rendered  by  an  old  English  transla- 
tor, the  natural  history  of  the  world,  consisting  of 
thirty-seven  books,  and  treating  of  cosmography, 
astronomy,  geography,  physics,  agriculture,  com- 
merce, medicine,  the  useful  and  fine  arts,  the  moral 
constitution  of  man,  and  the  history  of  nations,  as 
well  as  natural  history  proper.  The  compass  of  the 
work,  of  necessity,  included  numerous  topics  with 
which  the  author  was  not  personally  familiar.  He 
has,  therefore,  not  aimed  at  originality,  and  has 


*  Caii  Plinii  Secundi  Historise  Katuralis  libri  xxxvii.  vols,  6,  Lipsiae, 
1830. 


DISCOURSE.  139 

mostly  restricted  himself  to  condensing  and  trans- 
cribing from  other  writers.  Nor  has  he  in  this  labor 
evinced  much  talent  as  a  discriminating  compiler. 
He  is  neither  choice  in  his  selections,  accurate  in  his 
quotations,  nor  unbiased  in  his  judgment.  But  he 
has  condensed  his  materials  from  more  than  two 
thousand  authors,  and  from  the  reading  of  his  whole 
life ;  and  has  thus  furnished  us  with  one  of  the 
most  valuable  of  the  literary  remains  of  the 
ancients. 

Like  many  of  his  countrymen,  Pliny  has  not  con- 
cealed his  prejudice  against  the  profession.  He  was 
friendly  to  the  art  rather  than  to  those  who  practiced 
it.  But,  from  his  medical  reading  he  has  given  ten 
books  on  the  history  of  plants,  including  their  uses 
in  domestic  economy  and  the  arts;  ^ve  books  on 
the  medical  uses  of  plants ;  and  ^ve  others  on  medi- 
cines derived  from  the  animal  kingdom.  We  are 
indebted  to  him  for  an  account  of  several  epidemics 
and  new  diseases  ;  particularly,  for  his  graphic  his- 
tory of  Mentagra,  a  disease  which  appeared  at 
Rome  for  the  first  time,  during  the  reign  of 
Claudius,  and  spread  extensively  among  the  nobil- 
ity, sparing  women  and  persons  in  humble  life ; 
communicated  from  one  individual  to  another  by 
the  act  of  kissing;  appearing  first  upon  the  chin, 
lips,  and  face,  and  afterwards  extending  over  the 
surface  of  the  body,  in  the  form  of  eruptions,  which 
degenerated  into  foul  and  offensive  ulcers.  The 
close  analogy  of  this  disease  to  that  which  first 
appeared  in  the  south  of  Italy  near  the  close  of  the 
fifteenth  century,  led  many  at  first  to  the  belief,  that 
the  Mentagra,  or  Lichen,  of  Pliny,  was  identical  with 


140  DISCOURSE. 

tlie  venereal  disease  ;  and  this  disease,  from  first  ap- 
pearing on  tlie  pudendum,  was,  by  Gasper  Torrella 
and  others,  for  a  time  called  Pudendagra.  An- 
other interesting  point  in  Pliny's  history  of  the 
Roman  epidemic,  is  that  he  distinctly  ^lludes  to  the 
subject  of  contagion.  The  disease,  he  tells  us,  had 
previously  existed  in  the  East,  where  it  was  called 
by  the  Greeks,  Lichen ;  and  its  contagion,  he  adds, 
was  imported  by  a  Roman  knight,  who  communi- 
cated the  infection  to  the  inhabitants  of  the  capital. 
This,  it  is  true,  is  not  the  earliest  allusion  to  the 
subject.  Thucydides,  as  already  shown,  speaks  of 
the  plague  as  an  infectious  disease;  and  Aristotle, 
of  rabies  as  spreading  from  one  animal  to  an- 
other. Some  of  the  medieval  historians,  as  Eva- 
grius,"^  allude  to  the  contagiousness  of  plague.  But 
the  medical  writers  and  teachers  of  Greece  and 
Rome  were  too  deeply  involved  in  humoral  pathol- 
ogy and  the  doctrine  of  the  four  elements,  or  too 
much  disposed  to  reject  the  study  of  occult  and  re- 
mote causes  altogether,  to  understand  the  exact 
bearing  of  this  important  subject;  which  appears 
never  to  have  seriously  entered  into  their  discus- 
sions, and  which  was  equally  overlooked  by  the 
Arabic,  and  with  the  exception  of  Bernard  Gordon, 
by  most  of  the  European  medieval  writers  on  medi- 
cine.f     Pliny's  allusion  to  contagion  is  merely  inci- 

*  Ecclesiastical  History,  "book  iv.  chapter  xxix. 

f  Gordon's  list  of  contagious  diseases  is  summed  up  in  the  following 
distich : 

Febris  acuta,  phthisis,  pediculi,  scabies,  sacer  ignis, 
Anthrax,  lippa,  lepra,  nobis  contagia  praestant. 

Particula  i.  cap.  xxii.  p  llY. 

And  when  we  remember  that  Gordon  wrote  in  the  year  1305,  nearly  two 


DISCOURSE.  .  141 

dental ;  yet,  it  is  tlie  announcement  of  a  truth,  not 
of  a  speculation,  derived  from  popular  observation 
and  belief;  a  truth,  long  unheeded,  but  which  no 
one  at  the  present  day  would  venture  to  call  in 
question. 

Pliny  also  enters  fully  into  the  history  of  ancient 
wines,  and  in  speaking  of  the  strong  Falernian 
varieties,  says  they  are  inflammable :  "  Nee  ulli  in 
vino  major  auctoritas  ;  solo  vinorum  flamma  accendi- 
tur."f  The  modern  wines,  with  only  their  natural 
supply  of  alcohol,  are  not  of  strength  equal  to  this. 
It  is  therefore  reasonable  to  infer  that  the  art  of  dis- 
tillation must  have  been  known  to  the  vintners  of 
antiquity.  If  so,  it  must  have  been  confined  to 
some  single  fraternity  of  them,  and  practiced  as  one 
of  their  secret  mysteries,  only  for  the  purpose  of 
fortifying  their  wines ;  and  thus  kept  secret  until 
alcohol  was  discovered  anew  by  the  alchymists  of 
the  middle  age,  and  the  art  of  distilling  it  made 
public,  for  the  first  time,  as  is  commonly  believed, 
by  Arnold  de  Villa  Nova,  in  the  latter  part  of  the 
thirteenth  century. 

From  what  has  now  been  stated  of  the  progress 
of  medicine  at  Rome,  we  may  safely  infer  that  the 
interval  between  Asclepiades  and  Galen,  a  period 
of  about  two  hundred  and  fifty  years,  was,  in  the 

centuries  before  the  venereal  disease  is  usually  supposed  to  have  origin- 
ated in  Europe,  the  following  passage  from  his  Lilium  Medicinse  (Particula 
i.  cap.  i.  p.  107)  is  worthy  of  special  observation  : 

"  Quoedam  comitissa  leprosa  venit  ad  Montem  pessulanum,  eratque  tan- 
dem in  cura  mea,  cui  cum  quidam  Bacchalarius  in  medicina  ministraret  ei, 
coiens  cum  ea,  earn  imprsegoavit,  et  perfectissime  leprosus  factus  est." 

f  Lib.  xiv.  c.  viii.  §  2. 


142  *  DISCOUESE. 

number  and  ability  of  its  writers ;  in  the  advance- 
ment of  its  teachers  in  anatomy,  physiology,  materia 
medica,  therapeutics,  hygiene,  pathology ;  in  the 
study  of  nature,  and  in  the  philosophy  of  medicine, — 
one  of  the  most  active  periods  in  the  whole  history 
of  our  art.  As  such,  it  is  more  worthy  of  notice, 
from  the  fact  that  the  native  Eomans  were  never 
seriously  devoted  to  the  cultivation  of  the  sciences. 
But,  quick  discoverers  of  the  useful,  they  knew  how 
to  improve  upon  the  suggestions  or  discoveries  of 
the  Greeks.  Their  immense  cloacae  for  the  drain- 
age of  the  city,  their  public  baths,  their  care  in  the 
selection  of  sites  for  new  towns,  villas,  and  private 
residences,  their  improvements  in  architecture,  and 
the  domestic  arrangement  of  their  dwellings,  as  set 
forth  by  Vitruvius  and  others,  are  sufficient  to  show 
that  the  lectures  of  their  Grecian  masters  on  the 
rules  of  health,  had  been  properly  appreciated,  and 
the  information  thus  diffused  amongst  them,  turned 
to  good  account.  But  these  improvements  in  the 
arts  of  civil  life,  were  of  comparatively  short  con- 
tinuance; so  that  Galen,  who  flourished  during  the 
reigns  of  Marcus  Aurelius  and  Commodus,  and  as 
late  as  Septimus  Severus,  was  the  last,  as  he 
is  also  acknowledged  to  have  been  by  far  the  most 
distinguished,  of  the  medical  teachers  of  the  Roman 
school.  But  before  alluding  further  to  this  great 
master  of  our  art,  we  must  for  a  moment  return  to 
the  provincial  institutions. 


DISOOUKSE.  143 


CHAPTER    IX. 

GREEK  WRITERS  AND  TEACHERS  NOT  OF  THE  ROMAN 
SCHOOL  BUT  CONTEMPORARY  WITH  IT. 

Among  the  Greek  writers  not  strictly  of  the  Ro- 
man school,  who  flourished  during  the  epoch  at 
present  under  consideration,  were  Dioscorides  of 
Anazarba,  Ruffus  of  Ephesus,  Aretaeus  of  Cappado- 
cia,  and  Marcellus  of  Sida. 

Mr.  Sharpe,  the  able  historian  of  Egypt,  makes 
Dioscorides  the  physician  of  Cleopatra.  But  Galen 
speaks  of  him  as  a  recent  writer  ;  and  from  his  own 
works*  it  is  evident  he  must  have  lived  as  late  as 
the  reign  of  Claudius.  He  was  probably  educated 
at  Alexandria,  which  still  retained  some  share  of  its 
early  celebrity.  He  subsequently  traveled  exten- 
sively in  Europe  and  Asia,  and  for  a  part  of  his 
life  was  occupied  as  an  army  surgeon.  His  great 
work  on  the  Materia  Medica,  the  only  complete 
treatise  of  the  sort  that  had  hitherto  appeared,  was 
the  result  of  much  personal  inquiry  and  experience  ; 
and  the  portions  of  it  not  thus  acquired,  were  drawn 
as  he  informs  us,  from  the  most  reliable  sources. 
Galen  speaks  highly  of  his  accuracy  ;  and,  as  an  au- 

*  Pedanii  Dioscoridis  Anazarbei  de  Materia  Medica  libri  quinqiie,  <fec. 
Lipsiae,  1829-30  ;  2  vols,,  Kuhn's  edition. 


144 


DISCOTJKSE 


thority,  his  name  is  hardly  yet  obsolete  among  the 
writers  on  the  materia  medica.  Besides  this  able 
treatise  in  ^ve  books,  he  has  left  a  work  on  poisons. 
To  him  is  also  ascribed  another  work  in  two  books, 
entitled  Euporista,  which  is  dedicated  to  Andro- 
machus  of  Crete,  physician  to  the  emperor  Nero. 
This  latter  work  was,  in  all  probability,  by  an- 
other hand.  Whoever  may  have  been  its  author, 
he  has  grouped  his  remedies  according  to  their 
therapeutic  actions,  and  their  application  to  par- 
ticular ailments. 

Ruffus  of  Ephesus  was  the  author  of  a  treatise  on 
anatomy,  a  short  essay  on  diseases  of  the  urinary 
organs,  and  a  fragment  on  the  use  of  purgatives,  all 
of  which  are  still  extant."^  His  treatise  on  the  Ma- 
teria Medica,  written  in  verse,  has  perished.  His 
anatomical  work  is  the  only  portion  of  his  writings 
worthy  of  special  notice,  and  this  is  of  some  value 
as  showing  the  condition  of  anatomical  science  im- 
mediately before  the  time  of  Galen.  His  descrip- 
tions are  mostly  taken  from  his  own  observations. 
He  alludes  to  the  dissection  of  the  human  body  as 
a  practice  permitted  in  a  previous  and  more  liberal 
age,  and  regrets  the  necessity  of  confining  his  own 
investigations  to  apes  and  other  animals  most  re- 
sembling man.  He  speaks  of  the  commissure  of  the 
optic  nerves,  of  the  arteries  as  containing  blood,  of 
the  heart  as  the  source  of  animal  heat,  of  life,  and 
of  the  arterial  pulse.     According  to  some  writers, 

*  Kuffi  Ephesii  Medici,  de  Appellationibus  Partium  Corporis  Humani 
libri  iii. ;  Tractus  de  Vesicse  ac  Renum  Affectibus,  et  Fragmenta  de  Medi- 
camentis  Purgantibus. — Medicse  Artis  Principes.     Venetiis,  1567. 


DISCOURSE.  145 

Kuffiis,  too,  was  physician  to  Cleopatra ;  but  more 
reliable  authorities  place  him  as  late  as  the  reign  of 
Trajan. 

Aretseus  of  Cappadocia*  appears  to  have  been 
educated  at  Alexandria,  or  at  least  to  have  resided 
in  Egypt.  For,  in  treating  of  cynanche,  a  disease  of 
which  he  has  furnished  an  admirable  description, 
he  dwells  upon  the  climate  and  modes  of  living 
there,  as  more  likely  to  give  rise  to  this  disease 
than  the  climate  or  modes  of  life  in  Coelosyria. 
The  period  at  which  he  wrote  is  uncertain.  Some 
have  placed  him  prior  to  the  reign  of  Augustus, 
and  others  after  the  time  of  Galen.  There  has  been 
as  much  discrepancy  among  critics  concerning  the 
sect  to  which  he  belonged,  as  concerning  his  place 
of  residence  or  the  period  at  which  he  flourished. 
Aretseus  is  one  of  the  most  original  and  elegant  wri- 
ters of  antiquity.  For  truth  and  accuracy  of  de- 
scription, some  have  even  placed  him  above  Hippo- 
crates. There  is  perhaps  no  modern  writer  to 
whom  he  can  be  more  aptly  compared  than  Heber- 
den.  He  appears  to  have  written  at  that  period  of 
life  when  the  mind,  tempered  and  enriched  by 
ample  experience,  is  more  disposed  to  rely  upon 
personal  observation  than  on  the  teaching  of  the 
schools,  and  to  pay  little  regard  to  theories  unsup- 
ported by  the  revelations  of  nature.  Starting  with 
a  thorough  acquaintance  with  the  science  of  his  day, 
taking  Hippocrates  as  his  model,  and  repudiating 
all  futile  speculations,  he  details  the  simple  results 

*  Aretsei  Cappadocis  Opera  Omnia  (Kuhn's  edition),  Lipsiae,  1828. 


146  DISCOURSE. 

of  his  own  experience,  in  a  systematic  treatise  of 
eight  books  on  the  history  and  treatment  of  acute 
and  chronic  diseases,  and  in  a  manner  so  striking 
and  appropriate  as  rarely  to  have  been  excelled. 
His  descriptions  of  marasmus,  of  phthisis,  of  an- 
gina, of  asthma,  and  of  mania,  are  frequently  re- 
ferred to  as  true  to  nature,  and  of  poetic  finish. 
Yet,  he  himself  acknowledges  his  inability  to  paint 
to  his  own  satisfaction,  the  ever-varying  shades  of 
disease ;  and  advises  every  young  physician  to  study 
for  himself,  and  not  to  trust  for  all  his  knowledge 
to  the  commentaries  of  his  instructors.  In  his  prac- 
tice he  employs  but  few  remedies,  and  never  the 
monstrous  compositions  so  much  in  vogue  among 
the  Romans.  He  makes  frequ  ent  use  of  evacuants. 
Emetics,  purgatives,  and  venesection,  are  his  main 
agents  in  the  management  of  acute  diseases;  in 
these  also  relying  much  on  regimen,  and  on  cooling 
and  refreshing  drinks.  But  in  the  management  of 
chronic  diseases,  his  practice  is  more  diversified. 
His  surgical  is  in  keeping  with  his  medical  ability. 
He  was  the  first,  so  far  as  I  remember,  to  use  the 
tyephine  for  the  cure  of  epilepsy.  He  employs  ca- 
theterism  in  mechanical  obstructions  of  the  urethra, 
resulting  from  vesical  calculus  ;  for  the  removal  of 
the  stone,  he  recommends  perineal  section,  by  an 
incision  immediately  below  the  scrotum,  and  extend- 
ing inward  to  the  neck  of  the  bladder  until  the 
urine  and  calculus  escape.  He  employs  the  actual 
cautery  for  opening  hepatic  abscess,  and  cauter- 
izes the  scalp  in  certain  diseases  of  the  head.  Be- 
sides his  treatise  on  acute  and  chronic  diseases,  of 


DISCOIJKSE.  14:7 

whicli  tlie  first  four  chapters  of  tlie  first  book  are 
lost,  he  was  the  author  of  works  on  surgery,  on 
fevers,  on  the  diseases  of  females,  and  on  the  prep- 
aration of  medicines ;  all  of  which  have  perished. 

Marc  ell  us,  of  Sid  a,  in  Pamphilia,  was  the  author 
of  a  medical  poem  in  forty-two  books,  in  which  he 
described  a  strange  malady  called  Lycanthropia,  a 
species  of  mania,  in  which  those  affected  growled 
aloud  like  wolves,  and  during  the  night  wandered 
at  large  in  lonely  places,  and  among  the  tombs; 
and  in  which  the  most  aggravated  period  of  the 
attack  was  usually  in  the  spring  time.  Marcellus 
flourished  about,  or  just  prior  to,  the  time  of  Galen,* 
and  is  quoted  by  Oribasiusf  and  Aetius.J 

Having  ventured  beyond  the  limits  of  the  capital, 
we  may  remark  that  many  of  the  physicians  who 
taught  or  practiced  there,  had  been  educated  in 
Asia  Minor,  in  the  cities  of  which  were  many  flour- 
ishing though  now  forgotten  schools.  The  names 
of  several  distinguished  Eoman  professors,  were  as- 
sociated with  Ephesus.  Among  these  was  Magnus, 
a  writer  on  the  pulse,  and  the  inventor  of  theriacae 
after  the  manner  of  Heras  and  Andromachus.  Of 
this  same  school  were  the  anatomist  Ruffus,  and  the 
second  as  well  as  the  third  Soranus. 

The  school  of  Pergamus,  to  which  we  have  already 
on  more  than  one  occasion  alluded,  was  still  a  flour- 
ishing institution,  and  the  theater  of  a  long  list  of 
able  teachers.     At  the  head  of  this  school  in  the 

*  In  the  Biograph.  Medicale  he  is  placed  under  Adrian  and  Marcus 
Aurelius. 

f  Synopsis,  lib.  v.  cap.  x.  p.  266.        X  Tetr.  ii.  serm.  ii.  c.  xi.  col.  254. 


148  DISCOURSE. 

early  part  of  the  first  century,  was  Quintus,  a  con- 
summate anatomist,  and  tlie  ablest  physician  of  his 
time  *  Though  not  mentioned  as  a  writer,  he  was 
followed  by  several  able  disciples,  as  Lycus*of  Mace- 
don,  Marinus,  Pelops,  Numisianus,  and  Satyrius;  of 
all  of  whom  Galen  speaks  in  admiration, — of  Mari- 
nus,  as  the  author  of  an  elaborate  treatise  on  an- 
atomy ;  and  of  the  others,  as  his  own  preceptors. 
He  further  informs  us,  that  at  the  Asclepion  of  this 
city,  built  by  Costunius  Rufinus,  the  friend  and  co- 
adjutor of  his  preceptor  Satyrius,f  the  pupils  were 
in  daily  attendance  upon  the  sick,  studying  their 
diseases  at  the  bed-side,  and  acquiring  such  chance 
acquaintance  with  the  organization  of  the  human 
body  as  could  be  obtained  from  witnessing  the  sur- 
gical operations  and  dissections  of  their  instructor. 
Even  after  Galen's  time,  this  school  maintained  its 
early  celebrity ;  and  we  are  told  that  the  emperor, 
Caracalla,  visited  the  city  expressly  for  obtaining 
the  advice  of  its  professors. J 

*  Galen,  vol.  xiv.  p.  602. 

f  Ibid.  vol.  ii.  p.  224-5,  and  elsewhere. 

\  Le  Clerc,  parte  premiere,  liv.  i.  chap.  xx.  p.  63. 


DISCOUKSE.  14:9 


CHAPTEE    X. 


GALEN. 

Claudius  Galen,*  tlie  prince  of  physicians,  was 
born  at  Pergamus,  A.  D.,  131 ;  and,  under  the  judi- 
cious care  of  his  father,  Nico,  received  every  advan- 
tage of  early  education  at  his  native  place.  At  the 
age  of  seventeen,  he  was  placed  as  a  student  at  the 
Asclepion  of  Pergamus,  under  Satyrius,  the  pupil 
and  successor  of  Quintus ;  and  in  the  course  of  his 
studies  had  the  advantage  of  instruction  from 
Stratonicus,  a  Hippocratic  rationalist,  and  from 
-zEschrion,  an  empiric.  On  the  death  of  his  father, 
Galen,  now  twenty-one  years  of  age,  removed  to 
Smyrna  to  continue  his  medical  studies  under  Pe- 
lops,  another  pupil  of  Quintus ;  and  to  pursue  the 
study  of  Platonic  philosophy  under  Albinus.  He 
next  retired  to  Corinth,  there  to  become  the  pupil 
and  assistant  of  Normiscianus,  also  a  former  pupil 
of  Quintus ;  and  subsequently,  he  traveled  through 

*  Claudii  Galeni  Opera  Omnia,  Kuhn's  edition,  20  vols.  8vo.  See  the 
Historia  Literaria  prefixed  to  this  edition,  from  the  pen  of  Ackermann;  see, 
also,  Sprengel ;  the  article  Galien  in  the  Biographie  Medicale ;  the  article 
Galen  in  the  Dictionary  of  Classical  Biography ;  and  a  cursory  analysis  of 
the  works  of  Galen,  so  far  as  they  relate  to  Anatomy  and  Physiology,  by  J. 
Kidd,  M.  D.,  in  the  Transactions  of  the  Provincial  Med.  and  Surg.  Associa- 
tion, vol.  vi.  p.  SOL 


150  DISCOURSE. 

various  countries,  spending  some  time  at  Alexan- 
dria, still  the  most  celebrated  school  of  medicine, 
and  was  there,  for  a  season,  the  pupil  of  Heraclia- 
nus,  a  professor  of  whom  he  speaks  in  the  highest 
terms. 

While  journeying  in  pursuit  of  knowledge,  he 
allowed  no  opportunity  to  pass  unimproved  for 
familiarizing  himself  with  every  circumstance  bear- 
ing directly  or  indirectly  upon  his  medical  and  phil- 
osophical inquiries ;  and  even  at  an  earlier  age,  he 
adopted  the  habit  of  writing  commentaries  on  the 
philosophical  works  to  which  his  attention  had  been 
directed. 

At  the  age  of  twenty-eight,  having  completed  his 
education,  he  returned  to  his  native  place,  and  by 
the  priests  of  ^sculapius,  was  placed  in  charge  of 
the  gymnasium  then  attached  to  their  temple,  and 
at  which  the  athletse  and  gladiators  were  in  the 
daily  habit  of  exercising.  The  office  of  physician  to 
this  institution,  he  held  for  several  years,  during 
which  time  he  had  constant  occasion  for  exercising 
his  talents  as  a  surgeon.  But  in  consequence  of 
political  disturbances,  he  again  retired  from  Perga- 
mus,  and  at  the  age  of  thirty-four  took  up  his 
abode  in  Kome. 

Here  he  was  not  long  in  making  himself  known ; 
a  few  successful  cases  among  persons  of  elevated 
social  rank,  placed  him  almost  immediately  at  the 
head  of  his  profession.  His  earliest  patron  was  Eu- 
demus,  the  peripatetic  philosopher  ;  his  next,  the 
wife  of  the  consul  Boetius.  His  cure  of  this  noble 
matron  was  rewarded  by  a  present  of  four  hundred 


DISCOURSE.  151 

gold  pieces ;  and  what  was  of  more  avail,  it  secured 
to  him  tlie  friendship  of  the  consul;  of  the  praetor, 
Sefgius  Paulus ;  of  Barbatus,  the  uncle  of  the  empe- 
ror ;  of  Marcus  Aurelius  himself;  and  of  his  brother 
Lucius  Verus,  then  associated  with  him  on  the 
throne. 

This  rapid  promotion  was  not  without  its  disad- 
vantages. It  excited  against  Galen  the  vituperation 
of  certain  members  of  the  profession;  and  he,  in 
turn,  was  not  backward  in  expressing  his  con- 
tempt towards  all  who  had  undertaken  to  op- 
pose him.  But,  rising  by  the  force  of  merit,  he 
maintained  without  difficulty  the  position  he  had 
acquired.  To  silence  his  opponents,  he  opened  a 
school  of  anatomy,  which  still  further  increased  his 
popularity,  and  attracted  to  his  demonstrations 
not  only  students  of  medicine,  but  philosophers, 
politicians,  and  others,  of  the  highest  rank  and  in- 
fluence. After  he  had  been  thus  occupied  for  three 
or  four  years,  his  patrons  of  Rome  were  suddenly 
dispersed  by  an  epidemic ;  and  after  their  retirement 
to  their  usual  summer  retreats,  Galen,  too,  left  the 
city  for  Campania.  Spending  some  time  here,  and 
at  Brundusium,  h.e  afterwards  set  out  on  a  visit  to 
,:  the  East ;  but,  before  the  close  of  the  year,  he  was 
i'"''"  recalled  from  Pergamus  by  Marcus  Aurelius,  then 
in  Aquileia,  with  his  brother  Lucius  Verus,  pre- 
paring for  a  military  expedition  against  the  Mar- 
comanni,  and  who  had  assigned  to  Galen  the 
business  of  providing  medical  stores,  and  making 
■•'such  preparations  as  were  necessary  for  the  medical 
care  of  the  army. .    Accordingly,  hastening  through 


152  DISCOURSE. 

Cyprus,  Syria,  Thrace,  and  Macedonia,  he  directed 
his  course  to  Rome,  and  thence  towards  Aquileia. 
But  the  epidemic  having  extended  thither,  and  his 
patron  Lucius  Verus  having  died  of  it,  the  expe- 
dition was  deferred,  and  Galen  seized  the  oppor- 
tunity to  resume  his  occupation  at  the  capitol.   Nor 
could  he  be  again  induced  to  join  the  army,  even  at 
the  solicitation  of  Marcus  Aurelius ;  assigning  as  an 
excuse  that  in  a  vision  he  had  been  warned  not  to 
do    so,   by   JEsculapius.      During   the    subsequent 
absence  of  the  emperor  in  the  north,   Galen  was 
successful  in  treating  his  two  young  sons,  Commo- 
dus  and  Sextus  ;  thereby  securing  the  favor  of  their 
mother,  Faustina.     Thus,  in   the  enjoyment  of  un- 
bounded popularity,  devoting  his  attention  to  the 
poor  as  well  as  to  the  rich,  and  giving  no  inconsider- 
able portion  of  his  time  to  teaching  and  writing,  he 
spent  the  vigor  of  his  life  in  Rome;  where  he  was 
still  residing,  though  disembarrassed  from  the  cares 
of  his  profession,  in  his  old  age,  as  late  as  the  reign 
of  Septimus  Severus.      At  a  still  later  period  he 
retired  to  Pergamus,  where  he  spent  his  later  years, 
and  where  he  died,  according  to  the  most  reliable 
authority,  about  the  close  of  his.  seventieth  year ; 
though  by  some  writers  he  is  said  to  have  survived 
to  an  extreme  old  age.     His  immense  erudition,  his 
glowing  eloquence,  and  the  almost  endless  labors 
of  his  pen,  not  less  than  his  profound  acquirements 
in  anatomy  and  every  other  department  of  the  heal- 
ing art,  had  raised  him  before  his  death  to  the  most 
exalted  rank ;  and  after  his  decease  the  people  of 
Pergamus,  proud  of  their  fellow-citizen,  and  desirous 


DISCOURSE.  153 

to    express   their   reverence   for   his   name,   struck 
medals  to  his  memory. 

The  personal  character  of  Galen  is  seen  in  the 
numerous  incidental  allusions  and  amusing  anecdotes 
scattered  through  his  writings,  some  of  which  are  of 
sufficient  importance  to  be  given  in  his  own  manner. 

"  Soon  after  my  arrival  in  Kome,"  says  he,  "  Glauco 
the  philosopher  took  a  great  fancy  to  me,  in  conse- 
quence of  my  reputed  skill  in  diagnosis.  Meeting  me 
accidentally  in  the  street  and  shaking  hands  with 
me,  he  remarked,  'I  have  fallen  upon  you  oppor- 
tunely. I  wish  you  to  visit  with  me  a  patient  in 
this  neighborhood  whom  I  have  this  moment  left — the 
Sicilian  physician  whom  you  saw  walking  with  me 
some  days  since,  and  who  is  now  ill.'  I  inquired  of 
him  what  ailed  his  friend  ;  when  with  his  habitual 
candor  he  replied,  that  Gorgias  and  Apelas  had 
spoken  to  him  of  my  skill  in  diagnosis  and  progno- 
sis, which  appeared  to  them  more  like  the  result  of 
divine  inspiration  than  of  medical  science  ;  and  that 
he  wished  to  know  for  himself  whether  I  really  was 
thus  skillful.  He  had  hardly  done  speaking  before 
we  reached  the  door  ;  so  that  I  had  no  opportunity  of 
replying  to  his  request — as  I  have  often  said  to  you — 
that  on  some  occasions  the  signs  of  disease  are  cer- 
tain, at  other  times  they  are  ambiguous,  and  require 
to  be  considered  again  and  again.  But  as  we  enter- 
ed, I  observed  a  servant  carrying  from  the  sick 
chamber  a  vessel  containing  a  thin  bloody  sanies, 
like  the  recent  washing  of  flesh,  a  sure  evidence  of 
diseased  liver.  Av'ithout  appearing  to  notice  this 
circumstance,  I  proceeded  with  Glauco  to  the  pa- 
ll 


154:  DISCOURSE. 

tient's  apartment ;  when  placing  my  fingers  on  the 
wrist  of  the  sick  man,  I  examined  his  pulse  in 
order  to  determine  whether  the  attack  was  inflam- 
matory, or  simply  a  weakness  of  the  affected  vis- 
cus.  As  the  patient  was  himself  a  physician,  he  re- 
marked that  he  had  recently  been  up,  and  that  the 
effort  at  rising  might  have  accelerated  the  pulse ; 
but  I  had  already  discovered  the  evidences  of  in- 
flammation ;  and  seeing  on  a  recess  in  the  window  a 
jar  containing  something  like  a  preparation  of  hys- 
sop in  honey  and  water,  I  knew  that  he  had  mistak- 
en his  disease  for  pleurisy ;  in  which,  as  in  inflamma- 
tions of  the  liver,  there  is  usually  pain  under  the  false 
ribs.  He  had  been  led  to  this  opinion,  as  I  at  once 
perceived,  by  experiencing  this  pain,  by  his  short 
and  hurried  breathing,  and  by  a  slight  cough.  Under- 
standing the  case,  therefore,  and  turning  to  good 
account  what  fortune  had  thrown  in  my  way,  in 
order  to  give  Glauco  a  high  opinion  of  my  ability,  I 
placed  my  hands  over  the  false  ribs,  on  the  right  side 
of  the  patient,  and  at  the  same  time  declared  this 
to  be  the  seat  of  pain  ;  which  the  sick  man  admitted 
to  be  correct.  Glanco,  supposing  I  had  made  this 
discovery  merely  by  examining  the  pulse,  began  to 
express  surprise.  But  to  increase  his  astonishment, 
I  added, '  Inasmuch  as  you  admit  the  existence  of  pain 
at  this  spot,  I  wish  you  further  to  say  whether  you 
are  troubled  with  a  slight  cough,  and  whether  your 
cough  is  not  dry,  without  sputa,  and  occurring  at  long 
intervals.'  While  I  was  yet  speaking  the  sick  man  was 
seized  with  a  cough  such  as  I  had  described ;  whereat 
Glauco  was  exceedingly  excited,  and  no  longer  able 


DISCOURSE,  155 

to  contain  himself,  began  to  vociferate  in  praise  of 
my  abilities.  *  Do  not  think/  said  I,  '  that  these  are 
all  the  discoveries  my  art  enables  me  to  make  ;  there 
are  others  yet  to  be  mentioned,  which  will  elicit  the 
testimony  even  of  the  patient'  Then  turning  to 
the  latter  I  resumed :  '  Is  not  the  pain  in  this  part 
increased,  and  accompanied  with  a  sense  of  weight  in 
the  right  hypochondrium,  whenever  you  take  a  full 
breath  ? '  At  hearing  this  the  patient  also  was  sur- 
prised, and  was  as  loud  in  my  praise  as  Glauco.  See- 
ing fortune  still  smiling  upon  me,  I  was  desirous  of 
making  some  remark  in  reference  to  the  shoulder, 
which  appeared  to  be  drawn  downwards,  as  often 
occurs  in  severe  inflammations  as  well  as  in  indura- 
tion of  the  liver ;  but  I  did  not  venture  to  speak  on 
this  point,  fearing  to  diminish  the  admiration  which 
I  had  already  excited.  Nevertheless  I  touched  upon 
it  cautiously;  saying  to  the  patient,  'You  will  not 
long  feel  the  shoulder  drawn  downwards,  if  per- 
chance you  do  not  find  it  so  already.'  When 
he  admitted  this  symptom  also,  seeing  him  great- 
ly astonished,  I  said,  '  I  will  add  but  one  other  word 
to  show  what  you  conceive  to  be  the  nature  of  your 
complaint.'  Glauco  declared  he  would  not  be  sur- 
prised if  I  should  do  even  this.  But  the  patient, 
overcome  with  wonder  at  such  a  promise,  observed 
me  closely,  waiting  for  what  I  should  say.  I  told  him 
he  had  taken  his  disease  to  be  a  pleurisy.  This,  with 
a  further  expression  of  surprise,  he  admitted  to  have 
been  his  own  opinion,  as  well  as  that  of  his  attend- 
ant; who  had  been  fomenting  his  side  with  oil,  for 
the   relief   of  that    disease.      From   this   time  for- 


156  DISCOURSE. 

ward  Glauco  entertained  the  highest  opinion  both  of 
me  and  of  our  art ;  for,  having  never  before  come 
in  contact  with  a  physician  of  consummate  ability, 
he  had  hitherto  formed  but  an  humble  estimate  of 
the  profession.  I  have  related  to  you  these  par- 
ticulars," he  adds,  as  if  addressing  a  class  of  stud- 
ents, "  in  order  that  you  may  understand  that  there 
are  symptoms  peculiar  to  particular  diseases,  and 
others  common  to  several  diseases ;  and,  further, 
that  there  are  some  symptoms  inseparable  from  the 
disease,  some  usually  accompanying  it,  others  again 
of  uncertain  character,  or  of  rare  occurrence ;  so 
that  if  fortune  at  any  time  offers  to  you  a  good  op- 
portunity, as  in  the  instance  just  related,  you  may 
know  how  to  take  advantage  of  it ;  remembering 
that  fortune  often  presents  to  us  the  means  of  ac- 
quiring fame,  which,  through  ignorance,  many  are 
unable  to  turn  to  good  account.""^ 

The  following  is  equally  characteristic:  "There 
are,"  says  he,  "  certain  persons  who  promise  to  prove 
that  the  arteries  do  not  contain  blood,  yet  never 
test  their  assertion  by  dissections.     A  teacher  off 
this   sort   having  asserted  his  ability  to  show  that  ^' 
the  aorta  is  always  empty,  and  not  demonstrating! 
the  fact,  was  exhorted  to  do  so  by  a  number  of  ( 
ambitious  young  men  who  had  provided  animals  fori 
the  purpose.     At  first  he  refused  to  comply  withi 
their  request  unless  suitably  rewarded ;  whereupon 
they  placed  before  him  a  thousand  denarii  as  an 
inducement  to  prove   his   assertion.     After  much 

*  De  Locis  Aflfectis,  lib.  v.,  c.  8 :  Kuhn's  edition,  vol.  8,  p.  361, 


DISCOURSE.  157 

prevarication,  wlien  urged  to  proceed  by  all  pres- 
ent, lie  took  tlie  scalpel  in  hand,  and  began  by 
making  an  incision  in  the  left  side  of  the  chest, 
where  he  imagined  the  artery  could  be  exposed ; 
but  such  was  his  want  of  anatomical  skill  that  he 
cut  directly  down  upon  the  bone.  One  of  his 
associates,  however,  having  opened  through  the  inter- 
costal spaces,  he,  again  proceeding,  injured  in  the  first 
place  the  artery,  and  afterwards  the  vein.  The 
young  men  who  had  deposited  the  money  with  the 
spectators,  now,  laughing  at  him,  undertook  the 
experiment  themselves.  They  dissected  through 
the  intercostal  spaces,  as  they  had  been  previously 
taught  by  me,  in  such  a  way  as  not  to  injure  the 
vessels ;  and  without  delay  surrounded  the  artery 
with  two  ligatures ;  one  at  its  point  of  departure 
from  the  heart,  the  other  where  it  rests  upon  the 
spine,  just  as  these  boastful  teachers  had  promised 
to  do,  in  order  that  when  the  animal  was  dead  one 
might  see,  from  so  much  of  the  vessel  as  lay  between 
the  ligatures,  whether  or  not  the  artery  was  empty 
of  blood.  But  when  it  was  not  found  to  be  empty, 
they  declared  that  an  incision  must  have  been  made 
in  it  at  the  time  of  applying  the  ligature ;  as  if  some 
other  individual,  and  not  these  teachers  themselves, 
had  promised  the  demonstration.  For  they  had 
never  tried  the  experiment  in  presence  of  witnesses, 
nor  could  they  have  had  much  skill  in  applying  the 
ligatures,  since  they  did  not  even  know  that  the 
artery  and  vein  both  extend  to  the  lower  boundary 
of  the  ribs."*     The  order  of  applying  the  two  liga- 

*  Admiais.  Anatomic,  lib.  iil  cap.  1.     See  also  Kuhn's  edition  of  Galen, 
vol  il  p.  642. 


158  DISCOPRSE. 

tures  given  above,  evinces  how  imperfect  must  ha  ^ 
been  Galen's  knowledge  of  the  course  of  the  bloo(, 
through  the  aorta. 

An  admirer  of  Plato  and  Aristotle  whose  doc- 
trines he  would  have  attempted  to  reconcile,  he  was 
the  strenuous  opponent  of  the  Epicureans.  After  a 
burst  of  indignation  against  all  who  would  place 
their  supreme  good  in  the  gratification  of  their  own 
will,  he  exclaims :  "  Why  should  I  waste  words  on 
such  men  !  Others  of  nobler  understanding  might 
well  censure  me  for  thus  perverting  the  sacred 
attribute  of  speech,  which  ought  to  be  reserved  for 
composing  hymns  in  adoration  of  the  Author  of  our 
being.  I  hold  true  piety  to  consist,  not  in  sacrific- 
ing to  him  hecatombs  of  bulls,  or  in  burning  incense 
of  cassia,  or  of  hundreds  of  fragrant  ointments,  to 
his  honor;  but  rather  in  ascertaining  for  myself, 
and  in  teaching  to  others,  something  of  his  wisdom, 
his  goodness,  and  his  power.  I  hold  it  to  be  the 
most  convincing  evidence  of  his  goodness,  that  he 
has  supplied  every  creature  with  what  is  most  con- 
venient for  its  use,  and  that  all  are  supported  by 
his  bounty.  On  this  account  it  becomes  us  to  cele- 
brate his  goodness  with  hymns  of  praise.  We  see, 
as  evidence  of  his  consummate  wisdom,  that  he  has 
chosen  the  means  most  appropriate  for  accomplishing 
his  own  designs.  And  seeiug  that  he  has  created  all 
things  agreeably  to  his  own  will,  we  have  evidence 
of  his  almighty  power."* 

Many  of  the  minor  works  ascribed  to  Galen  may 
have  been  composed  in  his  earlier  years ;  but  most  of 

*  De  Usu  Partium,  lib.  iii,  cap.  10,  vol.  iii.  p.  2E'r. 


DISCOURSE.  159 

ttose  upon  whicli  his  fame  reposes  were  written 
after  his  recall  to  Rome.  Some  portion  of  his  writ- 
ings, among  these  the  two  books  of  Anatomical 
Administrations  which  he  had  composed  after  the 
method  of  Marinus,  were  consumed  during  the 
conflagration  of  the  temple  of  Peace  and  the  de- 
struction of  his  own  dwelling ;  other  parts  have 
perished  since  his  death.  Yet  we  have  now  in  print 
and  assigned  to  him,  eighty-two  treatises,  the  gen- 
uineness of  which  is  undisputed ;  eighteen  upon 
which  the  critics  are  not  so  well  agreed ;  nineteen 
fragments,  more  or  less  voluminous ;  and  eighteen 
commentaries  on  Hippocrates.  To  which  should  be 
added  nearly  forty  treatises  or  fragments  of  trea- 
tises still  extant  in  manuscript.  His  works  now 
wholly  lost,  are  supposed  to  amount  to  one  hundred 
and  sixty  ;  about  fifty  of  which  were  on  medical 
subjects.  He  was  also  known  as  a  philosophical 
writer ;  and  to  have  devoted  a  portion  of  his  labors 
to  grammar  and  mathematics. 

The  works  most  highly  esteemed  in  the  Galenical 
collection,  are  the  Administrationes  Anatomicse, 
De  Usu  Partium  Corporis  Humani,  De  Locis  Af- 
fectis,  Methodus  Medendi,  another  treatise  on  the 
same  subject  addressed  to  Glauco,  De  Prsenotione, 
Ars  Medica,  and,  if  really  his,  the  work  entitled 
Medicus  or  Introductio,  which  by  some  critics  has 
been  ascribed  to  Herodotus,  one  of  his  immediate 
predecessors.  Worthy  to  be  associated  with  the 
foregoing  are  the  treatises :  De  Ossibus,  De  Ele- 
mentis,  De  Temperamentis,  De  Atrabile,  De  Facul- 
tatibus  j^aturalibus,  An  in  Arteriis  Natura  Sanguis 


160  DISCOUKSE. 

Contineatur,  De  Prsesagatione  ex  Pulsibns,  De 
Simplicum  Medicamentorum  Temperamentis  et  Fa- 
cultatibus,  De  Compositione  Medicamentoram,  De 
Curandi  Ratione  per  Venae  SectioDem,  De  Sanitate 
Tuenda,  Quod  Animi  Mores  Corporis  Temperamenta 
Sequantur,  De  Foetuum  Formatione,  and  a  few 
others. 

In  tlie  first  of  the  works  cited  above,  we  are  told 
of  the  few  occasions  enjoyed  by  the  ancients  for 
acquiring  correct  anatomical  knowledge.  The  first 
five  books  of  this  treatise  are  occupied  in  describing 
the  muscles/ many  of  which  are  here  mentioned  for 
the  first  time.  In.  connection  with  the  muscular 
system  he  speaks  of  the  blood-vessels.  In  the  sixth 
book  are  described  the  organs  of  digestion ;  in  the 
seventh,  the  heart ;  in  the  eighth,  the  respiratory 
organs  ;  in  the  ninth,  the  brain  and  spinal  marrow ; 
and  in  the  six  remaining  books,  which  have  per- 
ished, he  treated  of  the  eye,  the  tongue,  the  phar- 
ynx, the  larynx,  the  os  hyoides,  the  history  of  the 
arteries  and  veins,  the  cerebral  and  spinal  nerves, 
and  the  organs  of  generation.  Many  facts  incorpor- 
ated in  this  important  production  have  been  claimed 
to  be  the  discoveries  of  later  times. 

The  treatise  De  Usu  Partium,  written  soon  after 
his  return  to  E-ome,  is  also  replete  with  anatomical 
details,  interspersed  with  physiological  opinions ; 
but  is  rather  a  dissertation  on  final  causes  than  a 
strictly  anatomical  performance  :  the  author's  main 
object  being  to  disprove  the  doctrines  of  Epicurus 
and  demonstrate  the  existence  of  a  superintending 
Providence,    from    the    wonderful    adaptation    of 


DISCOURSE.  161 

means  to  ends  in  the  organization  of  the  human 
frame.  In  this  admirable  discourse  is  found  that 
eloquent  exposition  of  the  powers  and  uses  of  the 
human  hand,  the  leading  thought  of  which  may- 
have  been  borrowed  from  Anacreon,  but  upon 
which  no  subsequent  writer  has  been  able  to  im- 
prove. And  here,  too,  are  found  those  hymns  to 
the  Deity,  and  other  pious  ejaculations,  so  worthy 
of  the  philosopher  and  moralist.  This  work  is  in 
seventeen  books,  and  has  been  preserved  entire. 

The  treatise  De  Locis  Affectis  in  six  books,  was 
the  work  of  his  maturer  years.  In  this,  with  won- 
derful sagacity  he  points  out  every  part  of  the 
body  subject  to  pains,  convulsions,  paralysis,  or 
other  symptoms  ;  and  to  which  our  attention  should 
be  directed  for  investigating  into  the  causes  of  dis- 
ease. This  valuable  treatise,  which  is  occupied 
mainly  with  pathology  and  symptomatology,  the 
learned  Haller  held  in  higher  estimation  than  any 
other  of  Galen's  works. 

The  Ars  Medica  was  for  many  centuries  the  text- 
book upon  which  the  students  of  Salernum,  and 
other  schools  of  the  middle  ages,  were  examined 
before  receiving  permission  to  practice.  Commenc- 
ing with  the  definition  of  medicine,  it  treats  of  the 
signs  of  health,  of  the  temperaments  generally,  and 
of  their  influence  on  special  organs  in  health  and 
disease.  It  next  treats  of  the  signs  of  disease — gen- 
eral and  local,  of  prognostic  indications,  of  the 
causes  of  disease,  of  the  means  of  preserving  health 
and  of  restoring  it  when  disordered ;  thus  furnish- 


162  DISCOUESE. 

ing  in  small  compass  an  exposition  of  the  whole  of 
Galen's  system  of  medicine. 

The  Methodus  Medendi,  in  fourteen  hooks,  was 
the  work  of  his  old  age,  and  was  held  by  his  fol- 
lowers in  nearly  the  same  estimation  as  the  Ars 
Medica.  The  two  books,  on  the  same  subject, 
addressed  to  Glauco,  treat  mostly  of  generalities. 
More  information,  it  has  been  said,  may  be  obtained 
from  this  work  than  from  the  whole  medical  litera- 
ture of  the  Arabians.  Galen,  as  before  remarked, 
frequently  refers  incidentally  to  his  own  history, 
particularly  in  the  Administrationes  Anatomicse, 
Ars  Medica,  De  Usu  Partium,  De  Locis  Aflfectis, 
De  Prsecognitione  ad  Epigenem,  De  Antidotis,  De 
Theriaca  ad  Pisonem,  and  in  a  work  of  his  later 
years  entitled  De  Propriorum  Animi  cuj usque 
Adfectuum  Dignotione  et  Curatione. 

His  original  investigations  were  chiefly  in  the 
department  of  anatomy.  In  this  he  made  many 
discoveries,  mostly  in  the  muscular  system.  But 
from  the  manner  of  treating  the  subject,  it  is 
difficult  to  determine  precisely  how  much  of  his 
anatomical  knowledge  was  derived  from  his  own 
researches,  and  how  much  from  the  labors  of  his 
predecessors.  He  was  the  first  to  describe  the 
popliteal  muscle,  the  platysma  myoides,  the  sterno 
and  thyro  hyoidei,  and  probably  many  others.  In 
angiology  he  was  not  much  in  advance  of  the  early 
Alexandrians.  Like  them,  he  placed  the  origin  of 
the  veins  in  the  liver,  of  the  arteries  in  the  heart. 
He  was   familiar  with  the  anastomoses  of  the  tw^o 


D-ISCOUESE.  163 

orders  of  vessels ;  lie  traces  the  current  of  blood  from 
tlie  liver,  tlie  supposed  fountain  of  the  venous 
portion,  into  the  right  ventricle  of  the  heart,  and 
through  the  pulmonary  vessels  to  the  left  ventricle. 
He  was  acquainted  with  the  uses  of  the  opening 
between  the  right  and  left  auricle;  but  in  other 
respects  his  ideas  of  the  course  and  distribution  of 
the  blood  were  confused  and  incorrect.  He  appears 
to  have  made  several  discoveries  in  the  nervous 
system, — he  points  out  the  tubercula  quadrigemina, 
corpus  callosum,  and  septum  lucidum ;  he  derives 
the  nerves  of  sensation  from  the  brain,  those  of 
motion  from  the  spinal  marrow,  and  to  some  nerves 
he  assigns  both  sentient  and  motive  power ;  he 
denies  the  decussation  of  the  optic  nerves,  but  ad- 
mits their  junction  at  the  commissure.  He  describes 
the  par  vagum  and  its  connections  with  the  sympa- 
thetic.  Certain  organs,  as  the  heart  and  blood- 
vessels, he  supposes  to  be  destitute  of  nerves,  and 
hence  devoid  of  sensibility.  He  took  much  trouble 
to  determine  the  structure  and  development  of  the 
human  foetus.  He  allows  no  occasion  to  escape  for 
impressing  upon  his  students  the  importance  of 
anatomical  knowledge,  advising  them  to  inspect  the 
human  cadaver  when  possible ;  or  where  this  cannot 
be  obtained,  to  dissect  monkeys  and  other  animals. 
These  were  the  subjects  of  his  own  study ;  and  from 
them  nearly  all  his  own  anatomical  descriptions 
were  derived. 

In  respect  to  physiology,  he  speaks  of  the  living 
body  as  a  unit, — though  constituted  of  parts  or 
organs,  simple  and  compound,  of  humors,  and  of 


164  DISCOURSE. 

spirits.  With  Empedocles  lie  maintained,  that  all 
the  parts,  by  which  he  means  the  material  struc- 
tures, whether  simple  or  compound,  are  constituted 
of  the  four  primitive  elements, — fire,  air,  earth,  and 
water  ;  from  which  are  derived  the  four  correspond- 
ing qualities,  the  hot,  the  cold,  the  dry,  and  the 
humid. 

He  also  enumerates  four  humors ;  the  blood, 
which  is  red,  hot,  and  moist ;  the  phlegm,  which  is 
white,  cold,  and  humid  ;  the  bile,  which  is  yellow, 
hot,  and  dry ;  and  the  melancholia,  or  atrabile, 
which  is  black,  cold,  and  dry.  These  two  latter  he 
holds  to  be  partly  excrementitious.  From  the  combi- 
nation of  the  elements  and  their  respective  qualities, 
results  the  complexion  or  Chrasis,  of  each  part  or 
texture  of  the  body.  The  preponderance  of  one  or 
another  of  the  four  humors  gives  rise  to  the  corre- 
sponding temperaments.  In  common  with  the 
Peripatetics,  he  attributed  the  essential  phenomena 
of  life  to  certain  occult  forces  inherent  in  the  several 
parts  or  organs.  These  forces  he  divides  into  the 
vital,  the  animal,  and  the  natural.  The  seat  of  the 
first  is  in  the  heart ;  of  the  second,  in  the  brain  ; 
and  of  the  third  in  the  liver.  But  above  all  these 
forces  he  admits,  with  Hippocrates,  the  presiding 
and  ruling  influence  of  Nature ;  a  word  which  by 
ancient  usage  was  equivalent  to  the  modern  expres- 
sion, vitality,  vital  force,  organic  force,  or  principle 
of  life. 

The  spirits,  under  the  common  name  of  Pneuma, 
he  also  divided  into  the  vital,  the  animal,  and  the 
natural;  corresponding  with  the  respective  forces 


DISCOURSE.  165 

by  whicli  tlie  functions  of  the  body  are  performed. 
The  natural,  or  least  attenuated  of  the  spirits,  are 
evolved  from  the  blood  in  the  liver,  the  organ  in 
which  the  blood  itself  is  firs.t  elaborated.  Con- 
ducted with  the  blood  to  the  lungs,  and  there  ex- 
haling certain  impurities,  and  combining  with  the 
respired  air,  the  natural  are  converted  into  the  vital 
spirits ;  and  passijig  afterwards  to  the  brain,  the 
vital  become  still  further  attenuated  and  converted 
into  the  animal  spirits. 

The  functions  are  also  of  three  corresponding 
orders,  the  vital,  the  animal,  and  the  natural.  To 
the  first  of  these  belong  the  action  of  the  heart  and 
arteries,  the  passions  of  anger  and  revenge ;  to  the 
second  belong  the  intellectual  powers,  intelligence 
and  sensibility ;  to  the  third  belong  the  functions  of 
nutrition,  muscular  action,  and  generation;  and 
these  functions  he  further  divides  into  the  external 
and  internal.  By  the  intervention  of  the  pnenma, 
the  vital  force  produces  the  pulsation  of  the  heart 
and  arteries.  He  undertakes  to  prove  experiment- 
ally that  an  interspace  exists  between  the  lungs  and 
pleura,  in  which  the  respired  air  is  expanded.  He 
holds  that  the  blood  is  cooled,  the  pneuma  relieved 
of  its  fuliginous  particles,  and  the  blood  endowed 
with  the  vital  force,  by  the  process  of  respiration ; 
and  that  this  process  is  effected  by  means  of  the 
diaphragm  and  intercostal  muscles. 

The  brain  is  the  seat  of  the  rational  mind;  the 
heart  is  the  seat  of  courage  and  the  angry  passions  ; 
the  liver  is  the  seat  of  desire.     By  the  internal  pul- 


166  DISCOURSE. 

sation  of  the  brain,  the  pneuma  of  the  ventricles  is 
engendered,  and  in  these  ventricles  the  functions  of 
the  mind  are  executed.  The  passage  of  the  vital 
spirits  from  all  parts  towards  the  brain,  where  they 
acquire  new  qualities,  explains  in  what  way  the 
mind  is  influenced  by  the  body.  But  it  is  not  clear 
whether  he  looked  upon  the  mind  as  an  entity,  or 
as  a  mere  result  of  organic  action^  From  the  brain, 
by  the  agency  of  the  nerves,  sensibility  and  motive 
power  are  diffused  throughout  the  body ;  but  special 
forces  subordinate  to  the  mind,  preside  over  the 
functions  of  special  sense.  The  brain  in  the  per- 
formance of  its  functions  exudes  a  thin  pituitous 
humor,  which  is  discharged  through  the  foramina 
in  the  cribriform  plate  of  the  sethmoid  bone,  and 
escapes  through  the  throat  and  nostrils. 

The  natural  functions  are  accomplished  by  the 
pneuma,  through  the  medium  of  the  blood.  But 
every  organ  has  its  own  peculiar  forces  of  attraction, 
retention,  and  expulsion,  analogous  to  the  forces 
which  have  recently  been  called  endosmosis  and 
exosmosis.  Thus,  by  its  own  peculiar  power  the 
stomach  attracts  the  aliment,  retains  it,  concocts  it, 
or  expels  it.  The  genital  apparatus  of  the  two 
sexes  differ  only  in  this ;  that  while  in  the  male 
they  are  external,  in  the  female  they  are  wholly 
internal.  The  uterus  has  as  many  separate  cavities 
as  the  animal  has  mammary  glands.  The  seminal 
fluid  is  in  the  female  from  the  ovaries  ;  in  the  male, 
from  the  testes.  The  commingling  of  the  two  fluids 
results  in  a  male  or  female  foetus,  according  as  the 


DISCOUKSE.  167 

fluids  are  from  the  organs  of  tlie  right  or  left  side. 
The  placenta  supplies  the  foetus  with  blood  and 
pneuraa.  The  brain,  derived  directly  from  the  semi- 
nal fluids,  is  developed  before  the  heart. 

From  this  short  exposition  it  will  be  seen,  that  his 
physiological  opinions  were  mostly  hypothetical. 
Yet  in  many  points  he  entered  into  experimental 
inquiries  for  maintaining  them.  In  this  way  he 
established  the  influence  of  the  nerves  over  the 
voluntary  muscles  ;  and  the  existence  of  red  blood, 
instead  of  simple  pneuma,  in  the  arteries, — a  fact, 
however,  known  before  his  time. 

In  hygiene,  his  rules  are  characterized  by  minute 
refinements.  Among  the  fundamental  laws  of 
health,  he  asserts  that  the  different  parts  of  the 
body  are  maintained  in  healthy  action  by  those 
agencies  and  influences  only  with  which  they 
hold  special  relations.  He  distinguishes  men 
into  three  classes:  1st,  the  naturally  sound  and 
rugged,  living  at  ease,  and  able  to  bestow 
proper  care  upon  their  health  ;  2dly,  those  con- 
stitutionally feeble  and  delicate ;  lastly,  those 
whose  occupation  obliges  them  to  live  irregularly. 
His  four  epochs  of  life — infancy,  youth,  manhood, 
and  old  age — have  their  respective  tendencies  and 
immunities ;  the  last  period  he  looks  upon  as  for 
the  most  part  a  condition  of  disease.  By  carefully 
studying  the  circumstances  of  age  and  habit,  in  con- 
nection with  the  temperament,  he  establishes  his 
rules  of  health.  He  examines  in  detail  the  influence 
and  uses  of  what  are  called  the  non-naturals, — air, 


168  DISCOTTRSE. 

aliment,  exercise,  repose,  and  tlie  like.  His  precepts 
in  respect  to  these  are  judicious.  He  advises 
mothers  to  nurse  their  own  oiffspring ;  he  deprecates 
the  practice  of  attempting  to  strengthen  young  in- 
fants by  immersing  them  in  cold  water,  as  some- 
times advised.  He  was  an  advocate  for  a  rigid 
diet,  and  insists  that  no  occupation  should  be 
allowed  to  interfere  with  regular  daily  exercise. 

In  Pathology,  he  was  aware  of  the  importance  of 
tracing  the  general  symptoms  of  disease  to  the 
organs  or  parts  primarily  affected.  This  study  he 
has  illustrated  in  his  treatise  De  Locis  Affectis^  the 
ablest  of  his  pathological  works.  He  makes  health 
to  consist  in  freedom  from  pain,  and  in  the  easy 
and  unembarrassed  exercise  of  all  the  functions; 
implying  in  this  an  equable  intermixture  of  the 
four  elements,  and  proper  relation  between  the 
solids  and  fluids.  Disease,  on  the  contrary,  he  makes 
to  consist  in  a  disturbed  condition  of  one  or  more 
of  the  functions.  The  diathesis,  or  predisposition 
to  disease,  he  distinguishes  from  the  disease  itself. 
The  diseases  of  the  simple  parts  depend  in  general 
on  disproportion  in  the  union  of  their  elementary 
constituents.  The  distemper  itself  may  be  either 
material,  or  independent  of  matter.  The  symptoms 
of  disease  are  the  result  of  derangement  of  function, 
or  of  change  in  the  apparent  qualities,  or  of  dis- 
ordered secretions.  The  causes  of  disease  are  ex- 
ternal and  internal.  The  former,  or  the  Proca- 
tartic,  are  necessary  to  give  play  to  the  second, 
which  are  subdivided  into  the  antecedent  and  the 


DISCOURSE.  169 

conjoint.  The  most  frequent  of  the  internal  causes 
is  the  superabundance  or  the  degeneration  of  the 
humors. 

Plethora  is  the  result  of  a  relative  or  absolute 
superabundance  of  blood.     Cacochymia  is  from  the 
superabundance  of  the  other  humors  by  which  the 
blood  becomes  corrupted.     Every  alteration  of  the 
humors   from  their  healthy  condition  is   called  a 
putridity.     The  heat  developed  by  putridity  gives 
rise  to  fever,  by  being  communicated  to  the  heart 
and  arteries.      With  the  exception   of  ephemeral 
fever,  which  depends  on  some  particular  alteration 
in  the  pneuma,  all  fevers  arise  from  corruption  of 
the  humors.     Among  the  intermittents,  a  quotidian 
arises    from    corruption    in    the    phlegm ;    a    ter- 
tian, from  corruption  in  the  bile ;  a  quartan,  from 
a   corresponding   condition  of  the   atrabile.      The 
entrance  of  blood  into  parts  which  do  not  naturally 
contain  it,  gives  rise  to  inflammation.     If  the  blood 
thus  enters  simply,  the  inflammation  becomes  phleg- 
monous ;  if  accompanied  with  pneuma,  the  inflam- 
mation   is    pneumatous;    if   with    the    pituita   or 
phlegm,  it  becomes  oedematous  ;  if  with  the  yellow 
bile,  erysipelatous ;  and  if  with  the  atrabile,  scirr- 
hous.     Advocating    the    Hippocratic   doctrine   of 
critical  days,  he  attempts  to  support  it  on  grounds 
purely  theoretical,  and  drawn  from  the  periodical 
changes   in   nature,   or   the   influence  of  the  stars. 
His    fondness    for   subtile   refinement    is   nowhere 
more  clearly  seen  than   in   his  numerous  and,   as 
they  must  now  be  considered,  fanciful  divisions  of 
the  pulse. 

12 


170  DISCOURSE. 

In  Prognosis,  lie  appears  to  have  been  remark- 
ably skillful.  In  this  department  of  pathology  he 
enlarged  considerably  on  the  precepts  of  Hippo- 
crates. He  has  with  equal  perspicuity  treated  of 
indications  and  contra  indications ;  and  in  this  study 
he  demonstrates  the  superiority  of  the  system  and 
practice  of  the  rationalists,  over  those  of  the  empirics. 
The  essential  character  of  disease,  where  this  can 
be  discovered,  furnishes  the  most  reliable  indications 
of  treatment.  But  where  this  cannot  be  discovered, 
the  indications  may  be  taken  from  the  season  of  the 
year,  the  state  of  the  atmosphere,  the  temperament 
or  mode  of  life  of  the  patient,  or,  in  rare  and  ex- 
ceptional instances,  from  the  symptoms.  Health,  he 
holds,  is  maintained  by  supplying  similar  with  simi- 
lars, whilst  disease  is  overcome  by  opposing  con- 
traries to  contraries.  These  two  propositions  furnish 
the  key  to  his  whole  system  of  hygiene  and  thera- 
peutics. 

His  regimen  for  the  sick  is  in  strict  conformity 
with  that  of  Hippocrates.  But  in  his  mode  of 
managing  many  individual  ailments,  he  diverges 
widely  from  his  great  model.  The  nse  of  the  lancet 
and  of  purgatives,  he  at  times  appears  to  have 
carried  to  extremes.  Like  most  of  the  rationalists, 
he  made  use  of  cupping ;  but  leeches,  which  were 
first  introduced  into  practice  by  Themison,  and 
freely  used  by  the  Methodic  sect,  he  does  not  appear 
to  have  employed.  Although  not  specially  devoted 
to  surgery,  he  evinces  much  skill  as  an  operator  ;  he 
introduced  some  new  ideas  while  still  officiating  at 
the  gymnasium  of  his  native  place,  in  reference  to 


DISCOUKSE.  171 

the  treatment  of  injuries  of  the  nerves.  He  applied 
the  trephine  successfully  to  the  sternum  for  evacu- 
ating the  contents  of  an  abscess  behind  that  bone. 
He  had  on  four  occasions  witnessed  anterior  lux- 
ation of  the  femur ;  twice  he  cured  what  was  sup- 
posed to  be  spontaneous  luxation  of  that  bone  ;  and, 
what  speaks  no  little  in  favor  of  his  humanity,  he 
deprecates  the  use  of  caustics  and  the  cautery,  which 
were  so  generally  employed  and  so  much  abused  in 
ancient  times. 

In  his  several  works  on  the  Materia  Medica,  and 
on  medicinal  agents,  simple  and  compound,  he  again 
differs  widely  from  Hippocrates,  whom  he  else- 
where affects  to  follow.  For  though  he  occasionally 
discountenances  the  custom  of  administering  exotic 
medicines,  and  ridicules  those  who  despise  familiar 
plants,  yet  he  is  fond  of  heterogeneous  mixtures,  and 
quotes  with  approbation  many  of  the  complicated 
formulse  of  his  predecessors;  but  it  is  to  be  ad- 
mitted that  his  own  confections  are  not  so  complex 
as  those  which  he  borrows  from  other  authors. 
The  doctrine  of  primitive  qualities  he  extends  to 
his  medicinal  agents;  and  these  qualities  he  de- 
duces from  the  corresponding  secondary  properties : 
thus,  bodies  primarily  hot  are  salt;  and  those 
primarily  dry,  are  bitter.  Again,  each  of  the  four 
primitive  qualities  may  exist  in  the  first,  second, 
third,  or  fourth  degree :  thus,  chicory  is  cold  in  the 
first  degree,  and  pepper  is  hot  in  the  fourth.  Or 
the  agent  may  owe  its  medicinal  effect  to  the  union 
of  two  or  more  primitive  qualities  ;  thus,  it  may  be 
hot  and  dry,  or  cold  and  moist.  Each  viscus,  in 
consequence  of  the  analogy  between  its  primitive 


172  DISCOURSE. 

qualities  and  those  of  certain  remedial  agents,  exer- 
cises upon  these  agents  a  specific  or  peculiar  attrac- 
tion. Again,  the  qualities  of  agents  may  be  actual 
or  potential ; — -fire  is  actually  hot,  pepper  is  potenti- 
ally so.  This  distinction  is  still  observed  in  modern 
times  in  reference  to  the  cautery.  Certain  medi- 
cines, as  specifics,  purgatives,  several  of  the  poisons 
and  their  antidotes,  act  not  by  their  primitive  qual- 
ities, but  by  their  whole  substance.  The  art  of 
medicine  in  Gralen's  time  consisted  mostly  in  devising 
or  applying  particular  remedies  to  particular  dis- 
eases, each  ailment  having,  as  was  supposed,  its  own 
particular  remedy.  From  the  usages  of  his  con- 
temporaries in  this  respect  he  did  not  vary ;  and 
like  most  of  them,  he  had  his  shop,  in  which  his 
medicinal  compounds  were  prepared,  but  only  for 
legitimate  purposes.  He  had  a  horror  of  charla- 
tans of  every  stamp ;  and  that  branch  of  the 
apothecary's  business  which  the  moral  tone  of  mod- 
ern times  no  longer  tolerates,  the  open  sale  of 
poisons,  so  common  in  former  times,  he  condemns  in 
the  severest  terms. 

Galen  wrote  no  work  expressly  on  the  practice  of 
medicine  ;  but  he  has  left  a  complete  code  of  medi- 
cal science,  the  only  complete  code  of  which  we  read 
among  the  ancients.  Possessing  in  its  individual 
parts  no  great  originality,  made  up  of  the  doctrines 
of  his  predecessors  of  every  sect,  and  disfigured  by 
occasional  incongruities,  yet,  as  a  whole,  this  code  is 
remarkable  for  its  general  unity  and  consistency. 
But  its  fundamental  doctrines  are  too  often  the  cre- 
ations of  the  imagination.  In  all  his  works  Galen 
delights  to  display  his  erudition ;  and  notwithstand- 


DISCOURSE.  173 

ing  their  vast  number  they  are  mostly  written  in 
polished  style.  He  professes  to  be  the  admirer  and 
disciple  of  Hippocrates.  Yet  no  two  writers  on 
medicine  were  ever  in  style  and  substance  more  dis- 
similar. Hippocrates  wrote  with  the  terseness  of  a 
philosopher ;  Galen,  with  the  flowing  redundancy 
of  the  rhetorician,  allowing  nothing  to  remain  un- 
said, and  adorning  his  discourse  with  criticism, 
biography,  anecdote,  sarcasm,  vain-glorious  boast- 
ing, personal  narrative,  and  incidental  allusions  of 
every  sort.  But  his  brilliant  errors  no  less  than  his 
sterner  truths,  gave  popularity  and  influence  to  his 
writings.  It  does  not  appear  that  among  the  Latins 
he  was  at  first  received  as  favorably  as  among  his 
own  countrymen.  He  is  mentioned  neither  by 
Serenus  Sammonicus,  who  immediately  succeeded 
him  ;  nor  by  Marcellus  Empiricus,  who  wrote  two 
centuries  afterwards.  But  the  next  writer  of 
celebrity  among  his  own  nation,  Oribasius,  who 
was  a  contemporary  of  Marcellus,  appropriated 
nearly  the  whole  of  Galen's  doctrines;  and  Alex- 
ander Trallianus  calls  him  the  divine.  But  au- 
thority, however  transcendent,  to  be  enduring  must 
be  founded  on  truth  alone.  The  authority  of  Galen 
was  not  thus  founded ;  and  after  a  reign  of  more 
than  twelve  centuries,  he  has  fallen  from  his  high 
estate.  He  who  looked  upon  himself  as  superior  to 
Hippocrates,  who  held  that  the  latter  had  merely 
commenced  what  he  himself  had  been  able  to  carry 
to  completion,  lies  buried  in  the  accumulations  of 
his  own  labors ;  whilst  Hippocrates,  drawing  his  in- 
spiration from  the   developments   of    nature,  still 


174  DISOOTJESE. 

lives,  to  be  studied  with  as  muct  edificatioQ  by  the 
physicians  of  the  present  day  as  by  his  own  im- 
mediate disciples. 


CHAPTER    XI. 

LATIN    MEDICAL    WRITERS    SUBSEQUENT    TO    GALEN. 

With  Galen  closes  all  that  remains  of  the  school 
of  medicine  at  Rome,  and  all  that  was  aggressive  in 
the  scientific  advancement  of  the  ancients.  Most  of 
those  who  had  practiced  or  taught  the  art  at  Rome, 
up  to  this  period,  as  we  have  already  seen,  were 
Grecians  who  had  received  the  elements  of  their 
education  at  Alexandria  or  other  eastern  institu- 
tions. With  the  decadence  of  the  Roman  school, 
that  of  Alexandria  again  acquired  its  former  rank. 
The  intestine  commotions  and  misrule,  the  religious 
and  other  wars  of  the  empire,  from  the  death  of 
Marcus  Aurelius  to  the  accession  of  Constantine,  left 
but  little  opportunity  at  the  capital  for  cultivating  the 
arts  of  peace.  During  this  long  interval,  Italy  had 
but  few  attractions  for  men  of  learning.  And  after 
the  removal  of  the  imperial  court  to  Constantinople, 
the  scholars  that  still  lingered  about  the  palace  of 
the  Caesars,  were  attracted  from  the  Latin  portion  of 
the  empire ;  so  that,  from  the  time  of  Galen  to  the 
final  overthrow  of  the  empire  of  the  West,  Latin 
literature  can  boast  of  only  four  or  ^ve  medical 
authors  whose  works  have  been  deemed  worthy  of 


DISCOURSE.  .  175 

preservation.  The  first  of  these  was  Serenus  Sam- 
monicus,  a  junior  contemporary  of  Galen ;  the  second 
was  Theodore  Priscian ;  the  third,  Marcellus  Em- 
piricus,  physician  to  the  elder  Theodosius;  the 
fourth  was  Vegetius ;  and  the  last,  if  properly  be- 
longing to  the  ancients,  was  Macer  Floridus,  our 
notice  of  whom  must  be  reserved  to  a  subsequent 
chapter. 

Quintus  Serenus  Sammonicus  was  the  author  of  a 
medical  poem  of  considerable  literary  merit,*  which 
is  said  to  have  often  furnished  amusement  for  the 
leisure  hours  of  Geta  and  Septimus  Severus.  In  this 
work  he  treats  of  several  diseases  and  their  cure, 
after  the  manner  of  the  other  medical  writers  of 
that  period,  but  with  more  than  their  usual  taint 
of  superstition.  He  affects  a  peculiar  veneration  for 
the  numbers  three,  seven,  and  nine  ;  and,  though  he 
condemns  the  use  of  incantations,  he  recommends  an 
amulet  which  he  calls  the  Abracadabra,f  to  be  sus- 

*  Sereni  Sammonici  de  Medicina  Praecepta.  8vo.  Paris,  1846;  also,  the 
same  work  in  the  Medicin^e  Artis  Principes,  as  collected  by  H.  Stephanus. 
FoL  Venice,  1567. 

f  This  word  is  said,  bj  Selden,  to  have  been  the  name  of  one  of  the 
Syrian  divinities.     The  written  form  of  the  amulet  was  as  follows : 
Abracadabra 
abracadabr 
abracadab 
abracada 
a    b    r    a    c    a    d 
a    b    r    a    c    a 
a    b    r    a    c 
a    b    r    a 
a    b    r 
a    b 
a 
The  Talraudists  used  the  word  Abraclan  after  the  same  manner.     See 
Le  Clerc,  partie  i.  liv.  i.  chap.  xii.  p.  41. 


1T6  .  DISCOURSE. 

pended  by  a  string  and  worn  as  a  necklace  for  the 
cure  of  hemitritic  fever.  This  amulet  consisted  in 
writing  on  cloth  or  parchment,  the  word  Abraca- 
dabra in  full  on  the  upper  line,  and  on  every  suc- 
ceedino^  line  omittins^  a  sins^le  letter  until  the  initial 
letter  was  at  length  the  only  one  remaining  to  be 
written  on  the  last  line.  Thus  making,  by  means  of 
these  letters,  a  triangular  figure.  During  the  reign 
of  Caracalla,  the  use  of  charms  and  amulets  had 
become  so  alarming  that  an  imperial  edict  was 
issued  against  them.  Serenus  Sammonicus  gave 
offense  to  the  tyrant  by  disregarding  this  injunc- 
tion ;  and  he  is  said  to  have  paid  for  his 
temerity  with  his  life.  The  belief  in  charms  and 
incantations,  which  became  so  common  towards  the 
downfall  of  the  empire,  has  been  attributed  by 
some  writers  to  the  influence  of  the  false  philosophy 
of  Persia  and  the  East.  But  mysticism  and  credul- 
ity have  their  source  in  the  human  heart,  and  are 
everywhere  the  natural  offspring  of  ignorance  and 
intellectual  debasement. 

Theodore  Priscian,  a  pupil  of  Vindician,  physician 
to  Valentinian,  flourished  at  the  Eastern  capital,  and 
was  the  author  of  a  work  on  the  use  of  indigenous 
medicines.  He  appears  also  to  have  paid  much  at- 
tention to  the  diseases  of  women.  A  digest  of  his 
opinions  on  all  that  relates  to  the  obstetric  art  in 
connection  with  those  of  his  predecessors,  Cleopatra 
and  Moschion,  is  to  be  found  in  the  Harmonia 
Gynseciorum  of  Casper  Wolphius.*     A  Latin  poem 

*  Constituting  one  of  the  works  in  the  collection  entitled  Gynseciorum, 
sive  de  Mulierum  AfFectibus  Commentatii  Gr»corum  Latinorum  Barbaro- 
rum,  in  tres  tomas  digesti.     Published  in  4to.  at  Bale,  1586. 


DISCOURSE.  177 

on  weights  and  measures,  sometimes  ascribed  to  Q. 
Rhemnius  Fannius  Palsemon,  is  also  attributed  to 
Priscian.* 

Marcellus  Empiricus  flourished  about  the  close  of 
the  fourth  century,  some  time  after*  the  struggle  for 
the  supremacy  of  Christianity  in  the  empire  had 
been  crowned  with  complete  success.  He  was  by 
birth  a  Gaul,  a  native  of  Bordeaux,  and  as  already 
stated,  physician  to  the  elder  Theodosius.  From 
the  dedication,  and  other  passages  scattered  through 
his  book,  De  Medicamentis,f  it  is  evident  he  was  a 
Christian.  In  the  preparation  of  his  works,  which 
he  inscribes  to  his  sons,  he  has  consulted  some  few 
of  the  Greek,  but  more  of  the  early  Latin  authors ; 
among  whom  he  refers  to  Pliny,  Apuleius,  Cornelius 
Celsus,  Apollinaris,  and  Designatianus.  Among  the 
illustrious  men  who  were  of  his  own  city,  and  whom 
he  speaks  of  as  his  contemporaries  or  immediate 
predecessors,  were  Siburius,  Eutropius,  and  Auso- 
nius.  He  furnishes  a  lengthy  quotation  translated 
from  a  Greek  work  falsely  attributed  to  Hippoc- 
rates, but  makes  no  allusion  whatever  to  Galen,  a 
proof  that  the  prince  of  physicians  had  not  yet 
acquired  his  authority  among  the  Latin  schools. 
Marcellus  was  a  writer  of  no  originality.  What  he 
has  not  borrowed  of  other  writers,  he  admits  to  have 
been  derived  from  the  people  of  the  rural  districts. 
He  gives  a  sort  of  introduction,  consisting  of  transla- 
tions or  lengthy  quotations  from  earlier  writers,  and 


*  Priscianus,  Panckoucke's  edition  of  his  poems.     Paris,  8vo.  1845. 
f  See  the  Medicinfe  Artis  Principes  of  Stephanus. 


178  DISCOIJESE. 

particularly  from  Vindicianus,  whom  he  styles  Count 
of  the  Archiatri  to  Valentiniau.  In  the  body  of  his 
work,  he  treats  of  medicaments  and  their  applica- 
tion to  diseases  in  the  order  from  head  to  foot, 
after  the  manner  of  the  empirics,  of  whom  he  de- 
clares himself  a  follower.  Some  critics  charge  him 
with  plagiarism,  for  having  transcribed  without 
acknowledgment,  whole  chapters  from  Scribonius 
Largus.  But  it  is  to  be  remembered  that  the  lat- 
ter was  also  a  copyist,  and  the  pupil  of  Apuleius, 
from  whom  Marcellus  acknowledges  that  he  had 
drawn  a  portion  of  his  materials ;  so  that  the  pas- 
sages common  to  both  of  these  compilers,  may  owe 
their  identity  to  their  common  origin. 

Among  the  contemporaries  of  Marcellus,  and,  as  a 
writer,  observer,  and  scholar,  by  far  his  superior, — 
was  Vegetius  Renatus,  the  author  of  a  treatise  on 
Veterinary  Medicine,  in  four  books.*  In  the  first 
book  he  treats  of  the  pestilential  diseases  of  the 
lower  animals.  Of  which,  says  he,  there  are  seven 
kinds,  the  humid,  the  dry,  the  subcutaneous,  articu- 
lar diseases,  elephantiasis,  subrenal  disorders,  and 
those  which  he  calls  farciminous,  corresponding  with 
glanders  and  farcy  of  the  present  day.  Each  of 
these  he  takes  up  separately,  giving  in  a  systematic 
and  lucid  manner  their  respective  symptoms  and 
modes  of  treatment.  The  second  and  third  books 
are  devoted  to  local  diseases  and  injuries,  and  to 
the  bites  of  rabid  or  venomous  animals ;  the  fourth 


*  Vegetii  Renati  Artis  Veterinarise,  sive  Mulomedicinse,  libri  iv.  8vo. 
Bipinti  ex  Typographia  Societatis,  1787. 


DISCOURSE.  179 

to  the  anatomical  structure  of  beasts  of  burthen,  to 
their  changes  and  varieties  according  to  age,  coun- 
try, and  other  modifying  circumstances,  and  to  the 
various  confections  and  other  preparations  employed 
in  the  treatment  of  their  diseases.  The  work  is 
that  of  a  man  familiar  with  the  practical  details  of 
his  profession,  and  who  draws  less  from  other  writers 
than  from  his  own  experience. 


CHAPTER    XII. 

aEEEK   MEDICAL   WRITERS   SUBSEQUENT   TO    aALEN. 

Turning  from  the  Latins,  we  must  again  take 
up  the  line  of  progress  among  the  Greeks.  The 
earliest  of  these,  after  Galen,  whose  names  are 
deemed  worthy  of  attention,  were  Csesarius,  Ori- 
basius,  and  Nemesius ;  all  three,  though  contem- 
porary with  Marcellus,  appear  to  have  written  be- 
fore him,  and  to  have  flourished  between  the  acces- 
sion of  Constans,  A.  D.  350,  and  the  death  of  the 
elder  Theodosius,  A.  D.  395  ;  and  at  the  close  of 
this  period  came  the  partition  of  the  empire. 

Caesarius  was  the  younger  brother  of  St.  Gregory 
Nazianzen,  archbishop  of  Constantinople,  and  was 
the  earliest  Christian  physician  of  distinction  at  the 
imperial  court.     On  the  completion  of  their   ele- 


180  DISCOURSE. 

mentary  studies,  the  two  brothers,  Gregory  and 
Csesarius,  departed  on  the  same  day  from  their 
father's  house ;  the  one  to  complete  his  philosophical 
course  at  Athens,  still  the  principal  seat  of  Grecian 
arts ;  and  the  other,  to  pursue  his  medical  studies  at 
Alexandria.  After  a 'residence  of  five  years  at  the 
latter  city,  Csesarius  commenced  practice,  and  rose 
to  great  distinction  at  his  native  place,  Nazianzus,  a 
town  of  Cappadocia.  But  on  the  removal  of  his 
brother  to  Byzantium,  he  was  induced  to  follow 
him.  Under  the  patronage  of  Constans,  Csesarius 
soon  rose  to  the  senatorial  rank,  and  was  appointed 
Archiater,  or  physician  to  the  emperor.  In  the  en- 
joyment of  an  ample  patrimony,  he  practiced  his 
professioQ  gratuitously,  and  with  great  renown. 
Julian,  who  had  formerly  been  a  fellow-student  with 
Gregory,  at  Athens,  and  who  succeeded  to  the 
throne,  A.  D.  363,  desirous  of  the  services  of  Csesa- 
rius,  urged  his  return  to  the  ancient  religion  of  the 
state ;  and  notwithstanding  the  refusal  of  Caesarius, 
he  persisted  in  retaining  him  at  the  imperial  court. 
But  overcome  by  the  solicitations  of  his  brother,  he 
at  length  retired  to  his  native  place,  where  he  spent 
the  remainder  of  his  days.  Whatever  he  may  have 
written  on  medicine  is  lost,  though  some  of  his 
theological  writings  are  still  extant.*  His  brother, 
the  bishop,  lived  to  pronounce  his  funeral  oration. 
The  touching  eloquence  of  this  discourse,  even  at  the 
present  day,  fills  the  reader  with  emotion.f     Need 

*  Mosheim's  Institutes.     Harper's  edition,  N.  Y.  1845,  p.  249,  note, 
f  See  Extracts  from  Gregory  Kazianzen  in  the   Cours  de  Literature 
Grecque,  par  M,  Planche.     Paris,  1828,  tome  vil  p.  176-287. 


DISCOURSE.  181 

I  speak,  says  this  prelate,  of  his  great  acquirements ! 
need  I  speak  of  his  skill  in  medicine,  particularly  in 
that  admirable  department  of  the  art  which  enabled 
him  to  recognize  the  complexion,  temperament,  and 
principle  of  diseases,  and  thereby  to  arrest  their 
progress,  or  nip  them  in  the  bud  !  Who  is  so  un- 
aware of  his  talents,  so  unjust  towards  him,  as  to 
dispute  his  claim  to  the  highest  place  in  his  pro- 
fession !  Who  might  not  be  satisfied  to  rank  in  ex- 
cellence even  next  beneath  him!  In  proof  of  his 
abilities,  I  appeal  both  to  the  East  and  West ;  to 
those  of  every  region  among  whom  his  talents  have 
been  exerted. 

What  may  have  been  the  character  of  the  medi- 
cal institutions  of  the  empire  at  this  period,  Gregory 
has  not  undertaken  to  inform  us,  but  the  rivalry  of 
which  he  speaks,  between  the  literary  institutions  of 
Athens,  might  lead  us  to  suppose  that  the  same 
spirit  may  have  shown  itself  at  Alexandria.  There 
prevailed,  as  we  are  told  by  him,  in  most  of  the 
young  students  at  Athens,  a  complete  sophistic  furor. 
They  all  canvassed  for  their  master ;  for  it  was  not 
the  custom  to  attend  different  lecturers  at  the  same 
time ;  but  each  one,  as  a  rule,  attached  himself  to 
one  teacher.  The  poor  students,  especially,  lent 
themselves  to  this  business  of  recruiting,  since  they 
got  exemption  from  class  payment,  or  even  some 
degree  of  remuneration",  if  they  succeeded  in  bringing 
to  their  respective  sophists  a  good  supply  of  new- 
comers. An  unprejudiced  youth  could  scarcely  set 
his  foot  on  Attic  ground  without  being  already 
claimed  by  the  adherents  of  a  party ;  they  wrangled, 


182  DISCOURSE. 

they  struggled,  they  threw  themselves  around  him ; 
and  it  might  easily  happen  that  a  young  man  was 
torn  quite  away  from  the  teacher  whom  he  had 
come  to  attend.  The  whole  of  Greece  was  drawn 
into  this  partizanship  of  the  students  for  their  favor- 
ite sophists,  so  that  this  recruiting  was  carried  on  in 
the  streets  and  harbors  of  other  cities  also.  Nor 
were  the  literary  disputes  and  altercations  of  the 
different  schools  among  themselves,  less  animated ; 
indeed,  they  seldom  concluded  without  coming  to 
blows.* 

Oribasius,  of  whom  we  have  next  to  speak,  was  a 
native  of  Pergamus,  or,  as  some  assert,  of  Sardis. 
He  received  his  professional  education  under  Zeno 
of  Cyprus,  the  most  distinguished  professor  of  the 
fourth  century,  who  taught  first  at  Sardis,  and  after- 
wards at  Alexandria.  If  Csesarius  was  the  earliest 
of  the  Christian,  so  Oribasius  was  among  the  latest 
of  the  pagan  medical  writers.f  He  ranked  with 
the  philosophers  of  the  times,  and  his  influence  was 
such  that  Julian  was  principally  indebted  to  him 
for  his  accession  to  the  throne.  Early  commended  to 
Julian  by  his  talents,  by  similarity  of  tastes,  and  by 
their  common  devotion  to  the  ancient  religion  and 
institutions  of  the  nation,  he  became  his  intimate 
companion,  and  was  one  of  the  four  friends  who  were 
permitted  to   accompany  him   into  Gaul.     At  his 


*  Gregory  Nazianzen  as  cited  in  Ullmann's  Ecclesiastical  History.  See 
Westminster  Review,  Oct.  1851. 

f  Oribasli  Sardiani  Medici  longe  exellentissimi  Opera,  tribus  tomis  di- 
gesta,  Joanne  Baptista  Rosario  interprete,  in  the  collection  of  Stephanus; 
also  in  Coccius,  e  Collectione  Nicetae. 


DISCOURSE.  183 

request  he  undertook  a  journey  to  Delphos,  and 
received  from  that  oracle  the  memorable  response, 
that  hereafter  the  oracles  are  mute.  He  subse- 
quently officiated  as  quaestor  of  Constantinople ; 
and  in  the  capacity  of  physician  accompanied 
Julian  into  Persia ;  where,  after  the  disastrous 
defeat  of  the  imperial  forces,  he  watched  over  the 
wounded  emperor  in  his  dying  hours.  Banished 
by  the  successors  of  Julian,  he  spent  many  years 
in  exile ;  and  among  the  barbarians,  by  the  ex- 
ercise of  his  talents  he  rose  to  celebrity,  and  was 
held  in  the  highest  reverence.  He  was  subse- 
quently recalled,  and  restored  to  rank  and  honor ; 
and  he  is  said  to  have  survived  till  towards  the 
middle  of  the  fifth  century.  Familiar  with  the 
literature  of  his  profession  from  the  earliest  ages, 
he  undertook,  at  the  request  of  Julian,  the  labor  of 
compiling  from  his  predecessors  every  thing  of 
value, — a  labor  which  he  accomplished  in  a  work  of 
seventy,  or  seventy-two  books.  In  the  arrange- 
ment of  this  immense  work,  he  treated  first  of  the 
articles  of  diet  and  medicine  from  the  vegetable 
and  animal  kingdoms,  of  the  different  modes  of  pre- 
paring these,  and  of  their  pharmaceutical  admini- 
stration. He  next  directed  his  attention  to  the 
nature  and  anatomical  construction  of  the  human 
frame,  deriving  some  portion  of  his  materials  from 
his  own  dissections  of  monkeys  and  other  animals. 
He  then  proceeds  to  the  rules  of  health ;  and  next, 
to  the  study  of  diseases  in  general,  diagnosis,  prog- 
nosis, to  the  circumstances  and  symptoms  proper  to 
individual  diseases,  and  finally  to   the   treatment. 


184  DISCOURSE. 

Of  the  whole  of  this  encyclopedic  performance  we 
still  possess,  the  first  fifteen  books,  two  other  books, 
usually  considered  the  twenty-fourth  and  twenty- 
fifth,  certain  fragments  preserved  in  the  collections 
of  Mcetas,  and  other  fragments  on  bandaging,  and 
on  surgical  apparatus  for  the  treatment  of  fractures 
and  luxations.  In  the  distribution  of  his  several 
subjects,  each  chapter  is  headed  with  the  name  of 
the  author  from  whom  it  has  been  abridged  or 
taken  verbatim.  And  so  cautious  is  he  in  making 
these  acknowledgments  that  what  he  has  not  thus 
accredited  to  others  we  may  presume  to  have  been 
derived  from  his  own  experience:  many  such  chap- 
ters are  scattered  through  the  work.  Among  the 
authors  quoted  by  him  are  Hippocrates,  Diodes  of 
Charystus,  Ctesias,  Xenocrates,  Archigenes,  Men- 
emachus,  Sabinus,  Deuches,  Kuffus,  Philotimus,  the 
surgeon  Herodotus,  Antyllus,  Philagrius,  Plistonicus, 
Athenseus,  Agathinus,  Possidonius,  Zopyrus, — not  to 
mention  Galen,  upon  whom  he  draws  continually, — 
and  numerous  minor  authors.  After  completing 
this  collection,  he  prepared  a  synopsis  of  it  in  nine 
books,  which  he  dedicated  to  his  son,  and  which 
appears  to  have  been  intended  simply  as  a  syllabus 
for  students.  This  smaller  work  is  preserved  entire. 
There  is  still  a  third  production,  entitled  Euporista, 
dedicated  to  Eunapius,  as  well  as  certain  commen- 
taries on  Hippocrates,  which  some  writers  have 
attributed  to  Oribasius ;  but  the  ablest  critics  ascribe 
these  to  other  authors  of  much  inferior  merit. 
Among  the  most  important  portions  of  the  collec- 
tion which   are  presumed  to  be  original,  are  the 


DISCOURSE.  185 

rules  whicli  lie  lays  down  for  the  practice  of  gym- 
nastic exercise,  his  observations  on  the  physical  and 
moral  education  of  children  and  youth,  something 
in  physiology,  symptomatology,  and  general  thera- 
peutics, on  the  use  of  enemata,  and  on  the  abstraction 
of  blood.  He  alludes,  on  the  authority  of  Galen, 
to  the  partial  or  bent  fracture  of  the  long  bones  of 
children,  a  fact  which  appears  to  have  escaped  M. 
Malgaigne;  who,  in  his  history  of  surgery,  has 
accredited  the  first  description  of  this  accident  to 
Lanfranc,  a  surgeon  of  the  thirteenth  century.* 

Hospitals  and  other  Medical  Institutions  of  CJiristianity . 

Before  the  ultimate  overthrow  of  the  pagan  insti- 
tutions, while  Christianity  was  hardly  yet  in  the 
ascendant,  the  prelates  and  clergy  were  gradually 
acquiring  the  control  of  all  that  related  to  the 
physical  and  social  welfare  of  their  people.  The  re- 
ligious and  moral  instruction  of  their  flocks  consti- 
tuted but  a  portion  of  their  duties.  To  them  was 
also  assigned  the  care  of  the  orphan,  the  widow, 
the  friendless,  the  needy,  and  the  suffering ;  a  duty 
which  they  sometimes  performed  in  person,  some- 
times through  the  agency  of  special  officers  of  the 
church,  or  of  the  Benedictine  and  other  monks. 
This  custom  appears  to  have  originated  with  the 
local  organization  of  the  churches  in  the  time  of  the 
apostles.  It  was  still  in  use  up  to  the  period  of  the 
Decian  persecution,  A.  D.,  250;  soon  after  which, 

*  Cocciiis,  e  Collectione  Nicetse,  p.  135.  Malgaigne,  Introduction, 
(Euvres  d'Ambroise  Pare. 

13 


186  DISCOURSE. 

we  find  Cyprian,  bisliop  of  Carthage,  charging 
Novatus,  one  of  his  presbyters,  with  the  crime  of 
appropriating  to  his  own  use  the  property  which 
had  been  entrusted  to  him  for  the  benefit  of  the 
poor  and  destitute  of  that  diocese.*  As  yet,  how- 
ever, we  have  no  notice  of  buildings  set  apart  by 
the  church  for  charitable  uses  ;  nor  is  there  reason 
to  believe  that  any  such  existed  either  before  or 
during  the  protracted  periods  of  persecution,  nor  at 
any  time  prior  to  the  accession  of  Constantine,  who 
ruled  from  A.  D.  306  till  337,  and  under  whom 
Christianity  first  became  the  religion  of  the  state. 

The  edict  of  this  emperor  for  the  closure  of 
the  Asclepions,  as  well  as  the  other  remaining  tem- 
ples of  pagan  worship,  led  at  once  to  the  establish- 
ment of  hospitals  and  other  charitable  institutions 
under  the  auspices  of  the  church.  Constantine 
himself  took  an  active  part  in  providing  the  clergy 
with  funds  and  every  requisite  for  extending  the 
institutions  of  the  newly  adopted  religion  of  the 
empire  ;f  and  his  mother,  Helena,  devoted  all  her 
energies  to  the  founding  of  churches  and  benevo- 
lent institutions  at  Constantinople,  as  well  as  at 
Jerusalem  and  other  places.^  The  example  set  by 
this  devout  and  influential  woman  was  followed  by 
those  of  her  own  sex,  who  had  the  means  at  their 
command  in  every  part  of  the  empire.  During  the 
succeeding   reign,  by   order  of  Gallus  Caesar,  the 

*  See  Introductioa  to  Ecclesiastical  History  of  Socrates.    Bohn's  edition, 
page  ix. 

\  Eusebius,  book  x.,  chapter  vi.,  and  elsewhere. 

t  Theodoret,  History  of  the  Church,  book  i.,  chapter  xviii. 


DiscorESE.  187 

elder  brother  of  Julian,  tlie  groves  of  Daphne  in 
the  neighborhood  of  Antioch,  once  sacred  to  Apollo, 
were,  in  A.  D.  357,  dedicated  to  the  church.*  And, 
notwithstanding  the  subsequent  opposition  of  Julian 
to  this  measure,  the  grounds  within  which  had 
formerly  stood  the  magnificent  temple  of  Apollo 
Daphnseus,  were  occupied  by  an  hospital  for  the 
sick.f 

Again,  the  emperor  Valens  presented  the  most 
beautiful  lands  in  the  neighborhood  of  Csesarea  to 
Archbishop  Basil,  for  the  benefit  of  the  poor  whose 
bodies  were  afi*ected  with  disease,  as  being  those 
who  there  stood  most  in  need  of  assistance.^  And 
as  early  as  A.  D.  373,  Basil  had  already  organized 
at  Csesarea  an  immense  hospital  called  the  Basilides, 
which  Gregory  Nazianzen  thought  worthy  to  be 
reckoned  among  the  wonders  of  the  world,  so  nu- 
merous were  the  poor  and  sick  that  came  thither, 
and  so  admirable  were  the  care  and  order  with 
which  they  were  served. §  The  charge  of  the  suffer- 
ing within  the  walls  of  these  new  institutions,  was 
not  at  first  assigned  to  humble  hands.  The  most 
illustrious  ladies  of  the  empire  participated  in 
these  offices  of  mercy.  At  Constantinople,  the 
empress,  Flacilla,  wife  of  the  elder  Theodosius, 
A.  D.  380,  was  watching  with  solicitude  over  all 
those  whose  bodies  were  mutilated,  or  who  had  lost 


*  Select  Works  of  the  Emperor  Julian,  Duncombe's  translation.  Lon- 
don, 1784.     Vol.  i.  p.  247,  note. 

f  Evagrius,  Ecclesiastical  History,  book  iv.,  chapter  xxxv. 

X  Theodoret,  book  iv.,  chapter  xix.     Bohn's  edition,  p.  177. 

§  Ullman,  Ecclesiastical  History  of  the  Fourth  Ceutury.  See  West- 
minster Rev.,  Oct,  1851,  American  edition,  p.  56. 


188  DISCOUKSE. 

any  of  their  limbs.  She  visited  them  at  their  own 
dwellings,  waited  upon  them  herself,  and  supplied 
their  wants.  She  repaired  with  the  same  zeal  to 
the  public  hospitals  of  the  church,  where  she  tended 
the  sick,  made  ready  their  culinary  utensils,  tasted 
their  broth,  carried  the  dish  to  them,  broke  the 
bread,  divided  the  meal,  washed  the  cups,  and  per- 
formed for  them  all  the  offices  which  usually  de- 
volve upon  servants.* 

In  the  Code  of  Justinianf  we  find  a  summary  of 
the  edicts  issued  by  different  emperors  in  relation 
to  the  charitable  foundations,  and  the  duties  of  the 
several  officers  in  charge  of  them.  The  Orphano- 
trophi  officiated  as  guardians  to  the  orphans.  The 
Xenodochi  were  commissioned  to  give  accommoda- 
tion to  strangers  and  travelers.  It  was  at  the 
Stranger's  House  that  Ambrose,  bishop  of  Milan, 
received  the  emperor  Theodosius,  A.  D.  390,  on  his 
visit  of  reconciliation  to  that  prelate.  J  The  Brepho- 
trophi  had  the  care  and  protection  of  foundlings. 
The  Ptochotrophi  had  charge  of  the  poor ;  and  the 
Nosocomi  had  the  care  and  management  of  the 
sick.  These  several  functionaries  all  belonged 
to  the  order  of  the  clergy.  But  the  Perabolani, 
who,  to  the  number  of  six  hundred,  served  under 
the  bishop  of  Alexandria,  and  whose  duty  it  was  to 


*    Theodoret,  book  v.,  chapter  xix. 

f  Lib.  i.,  Tit.  iii.,  "De  Episcopis  et  Clericis,  et  Orphan otropbis  et 
Xenodocis  et  Brephotrophis,  Ptochotrophis  et  Aseetriis  et  Monachis,  et 
Privilegiis  eorum,"  <kc.  In  reference  to  the  Nosocomi  see,  also  under  the 
foregoing  title,  L.  42,  §§  6  and  9 ;  and  the  notes  of  Cujacius  on  the  third 
of  the  Nouvellse  Constitutiones ;  and  the  edict  of  Honorius  and  Theo- 
dosius, A.  D.  48*7,  in  reference  to  the  PerabolanL 

X  Theodoret,  book  v.  chapter  xviii.  Bohn's  edition,  p.  221. 


DISCOURSE.  189 

administer  to  tlie  sick  in  time  of  pestilence,  were 
uneducated  laymen.  Among  the  clerici  or  clergy, 
besides  the  prelates  and  officers  already  mentioned, 
were  presbyters,  archdeacons,  deacons  of  either 
sex,  sub-deacons,  ascetrise,  or  those  appointed  for 
religious  meditation,  readers  of  the  Sacred  Scrip- 
tures, exorcists,  ostiarii  or  door-keepers,  psaltse  or 
singers,  and  hermiae, — monitors  or  expositors.  These 
various  functionaries  received  the  appointments  not 
by  favor  of  their  superiors,  but  by  the  voice  of  the 
people  among  whom  they  officiated. 

The  duties  of  the  Nosocomi,  or  those  in  charge  of 
the  Nosocomia  or  hospitals,  imposed  upon  them  the 
necessity  of  familiarizing  themselves  in  some  mea- 
sure with  the  principles  of  medicine,  and  in  this 
way  they  were  prepared  to  practice  at  large  among 
the  people.  The  regularly  educated  lay  physicians 
were  thus  gradually  deprived  of  many  of  their  pre- 
rogatives, and  supplanted  by  the  clergy,  who,  in 
their  united  capacity  of  priest  and  physician,  were 
afterwards  for  many  ages  almost  the  only  prac- 
titioners of  medicine.  During  this  long  period 
many  of  the  higher  clergy,  as  well  as  of  the  humbler 
members  of  the  monastic  order,  were  distinguished 
as  writers  and  teachers  of  the  healing  art.  One  of 
the  earliest  of  these,  Nemesius,  bishop  of  Emesa, 
the  contemporary  and  friend  of  Basil  and  Gregory 
Nazianzen,  flourished  A.  D.  380,  and  was  the  au- 
thor of  a  work  on  the  Nature  of  Man,*  which  is 


*  Nemesius  Emesenus  De   Natura  Hominis,  Graece   et   Latine,  8vo. 
Magdeburg,  1802. 


190  DISCOUESE. 

still  extant — a  work  long  popular  as  a  text-book  in 
the  schools,  and  written  after  the  manner  of  Galen's 
treatise,  "  De  Usu  Partium."  In  this  work,  medi- 
cine, philosophy,  and  morality  are  intermingled. 
In  its  chapter  on  the  pulse,  some  critics  have 
imagined  they  could  discern  the  first  intimation  of 
Harvey's  great  discovery,  the  circulation  of  the 
blood.  The  worth  of  their  opinion  may  be  readily 
inferred  from  the  following  passage  ;  which  it  must 
be  admitted  is  a  clearer  exposition  of  the  subject, 
and  nearer  the  truth,  than  any  similar  passage  that 
can  be  cited  from  Galen  or  Aristotle :  "  The  movement 
of  the  pulse,  which  is  a  vital  function,  has  its  origin 
in  the  heart,  especially  in  the  left  ventricle,  which 
is  called  Spirabilis,  and  which  imparts  the  innate 
vital  heat  through  the  arteries  to  every  part  of  the 
body,  in  the  same  manner  as  the  liver  through  the 
veins  imparts  nourishment."  The  pathology  of 
fever  advanced  by  Nemesius  is  deduced  from  his 
theory  of  innate  heat,  and  is  evidently  borrowed 
from  Galen. 

The  assumption  of  the  duties  of  the  medical  pro- 
fession by  the  clergy,  was  effected  at  a  comparatively 
early  period  in  the  western  portion  of  the  empire, 
and  was  nearly  complete,  excepting  in  some  of  the 
larger  cities,  especially  of  Italy.  But  though  it  be- 
gan also  early  in  the  East,  it  does  not  appear  ever 
to  have  been  so  thorough  there.  The  Perabolani  of 
Alexandria,  who  seem  to  have  ranked  between 
the  uneducated  nurse  and  the  clerical  physician,  be- 
came so  troublesome  by  their  numbers  and  their  tur- 
bulent habits,  that  they  were  disbanded  by  their 


DISCOUKSE.  191 

superiors.  The  regular  teaching  of  medicine  in 
that  city,  as  well  as  the  business  of  general  instruc- 
tion there,  passed,  after  the  reign  of  Theodosius, 
directly  into  the  hands  of  lay  professors  of  the 
Christian  faith.  The  school  of  medicine  at  Alexan- 
dria, continued  to  flourish,  though  with  waning  lus- 
ter ;  and  from  it  issued  most  of  the  medical  writers 
whose  works  remain  to  be  noticed  among  the  later  of 
the  ancient  classics. 

The  first  practitioner  worthy  of  notice,  after  Ori- 
basius,  was  Jacob  Psychrestus,  who  flourished  at 
Constantinople  during  the  reign  of  Leo  the  Great, 
which  extended  from  A.  D.  457  to  474.  He  is  not 
known  as  a  writer,  but  he  is  mentioned  by  Alex- 
ander Trallianus*  as  a  practitioner  of  consummate 
ability.  He  was  educated  under  his  father,  Hesy- 
chius,  at  Alexandria.  He  officiated  as  Archiater 
under  Leo,  and  was  held  in  high  estimation  by  the 
Senate,  who  decreed  him  a  statue,  which  was  raised 
to  his  honor  in  the  Baths  of  Zeuxippus  ;  and  another 
was  still  existing  at  Athens  as  late  as  the  reign  of 
Justinian.f 

The  Last  of  the  Ancient  Latins. 

Before  again  returning  to  the  classical  medical 
writers  of  the  Eastern  empire,  not  knowing  where 
else  to  speak  of  the  only  remaining  Latin  pagan 
writer  of  the  profession  after  the  time  of  Oribasius, 
I  must  here  briefly  notice  the  hexameter  poem  "De 
Viribus  Herbarum,"  by  Macer  Floridus.J     M.  Bau- 

*  Lib.  V.  cap.  iv.  f  Freind,  vol,  i.  p  125. 

\  Par  M.  Louis  Baudet  (professeur).     Paris,  8vo.  1845. 


192  DISCOURSE. 

det,  I  am  aware,  is  disposed  to  class  this  work 
among  the  literary  performances  of  the  ninth  cen- 
tury. But  the  name  of  Strabus,  which  he  finds  in  it, 
and  upon  which  he  founds  this  opinion  under  the 
presumption  that  it  refers  to  Walafride  Strabo,  a 
German  ecclesiastical  writer  of  that  age,  is  no  proof 
that  the  author  of  this  poem  flourished  at  so  recent 
a  period ;  since  the  name  Strabo,  as  given  in  the 
poem,  is  quite  as  applicable  to  the  ancient  geog- 
rapher, or  to  any  other  ancient  author  who,  like 
him,  may  have  received  this  appellation  from  the  acci- 
dental disfigurement  of  a  strabismus.  Emilius  Macer, 
a  contemporary  of  Ovid,  was  also  the  author  of  a 
medical  poem  on  birds,  serpents,  and  plants.  And 
according  to  the  theory  of  M.  Baudet,  the  author  of 
the  work  "  De  Viribus  Herbarum,"  whose  real  name 
is  said  to  have  been  Odobonus,  adopted  the  name 
of  this  ancient  writer  in  order  to  give  greater  re- 
pute to  his  own  performance.*  But  the  first  lines 
of  the  poem  in  question  introduce  the  ancient  my- 
thology, and  could  hardly  have  been  written  by  any 
of  the  Christian  monks  of  the  ninth  century,  when 
literature  was  at  its  lowest  ebb  among  the  Latins, 
and  when  the  name  of  Emilius  Macer  was  perhaps 
as  little  known  to  the  medical  profession  of  western 
Europe  as  if  he  had  never  existed. 

The  style,  versification,  and  language  of  this 
poem  are  above  mediocrity,  and  are  in  imitation 
of  Serenus  Sammonicus.  It  begins  by  recogniz- 
ing Diana,  the  Artemis  of  the  Greeks,  among  the 
divinities  of  medicine.     It  is  divided  into  seventy- 


*  See.  also,  Le  Clerc,  p.  560. 


DISCOURSE.  193 

seven  sections,  each  of  which  is  devoted  to  the 
medical  virtues  of  some  particular  plant.  The  inter- 
est, however,  assigned  to  this  performance  at  the 
present  day,  is  in  its  display  of  learning.  Macer 
Florid  us,  says  M.  Baudet,  introduced  among  us  the 
knowledge  of  the  Greeks  and  Romans  in  natural 
history  and  practical  medicine  ;  and  he  supplies  ns 
with  many  curious  and  useful  documents,  not  only 
on  his  own  art,  but  also  on  the  manners  and  domes- 
tic usages  of  the  ancients.  To  this  commendation 
may  here  be  added,  that  he  is  the  earliest  of 
the  Latin  writers  to  speak  of  Galen,  or  as  he 
calls  him,  Galienus.  He  cites  Hippocrates,  Dioc- 
les,  Chrysippus,  Dioscorides,  Themison,  Strabo, 
Apollodorus,  Menemachus,  Oribasius,  the  elder 
Cato,  Sextus  Niger,  Pliny,  and  the  obscurer 
names  of  Anaxilaus  and  Melicius.  He  alludes 
occasionally  to  the  efficacy  of  charms,  but  he  is  free 
from  the  grosser  superstitions  of  the  monks  of 
the  middle  ages ;  and  with  the  exception  of  the  word 
"  frater,"  which  he  once  employs  as  a  term  of  ad- 
dress, we  could  hardly  suspect  him  to  have  been 
acquainted  with  the  institutions  of  Christianity. 


Aetius  of  Amida  in  Mesopotamia,  a  learned  phy- 
sician of  the  Christian  faith,  is  supposed  to  have 
flourished  about  the  middle  of  the  sixth  century. 
After  completing  his  education,  he  settled  in  Con- 
stantinople, where  he  rose  to  the  dignity  of  archia- 
ter  at  the  imperial  court,  with  the  honorary  title  of 


19i  DISCOURSE. 

colonel  of  the  imperial  guard.  We  are  indebted  to 
liim  for  a  voluminous  compilation  on  tlie  art  of 
medicine,*  mostly  copied  from  tlie  writings  of  his 
predecessors,  but  interspersed  with  original  observa- 
tions, and  often  presenting  the  opinions  of  earlier 
authors  so  condensed  and  well  expressed  as  to  be 
clearer  than  the  originals.  This  work  was  at  first 
prepared  in  sixteen  distinct  discourses,  which  have 
since  been  arranged  into  four  books  of  four  dis- 
courses each.  Of  these  discourses,  the  first  treats 
of  medicinal  plants  and  their  pharmaceutical  prepar- 
ation ;  the  second,  of  such  medicines  as  are  not  of 
vegetable  origin ;  the  third,  a  somewhat  confused 
medley  of  miscellaneous  subjects,  treats  mostly  of 
the  influence  of  air,  exercise,  climate,  locality,  waters. 
The  fourth  treats  of  the  management  of  children,  of 
the  humors  and  temperaments,  and  their  signs.  The 
fifth  discourse,  or  the  first  of  the  second  book,  treats 
of  the  signs  of  disease,  prognostic  and  diagnostic ;  of 
fevers  and  their  management ;  and  of  other  consti- 
tutional affections.  The  sixth  discourse,  and  the 
others  to  the  end  of  the  twelfth,  are  devoted 
to  the  consideration  of  local  diseases  from  head 
to  foot ;  the  thirteenth  treats  of  the  bites  and 
stings  of  animals,  including  poisoned  wounds.  Here 
also,  lej^ra  and  certain  other  diseases  affecting  the 
skin,  are  introduced.  The  fourteenth  discourse  is 
occupied  with  diseases  merely  of  a  surgical  charac- 
ter, affecting  the  groin,  perineum,  and  organs  of  gen- 


*  ^tii  Medici  Grseci  Contractae  ex  Veteribus  Medicinse  Tetrabiblos ;  id 
est,  libri  iiniversales  quatiior,  singuli  quatuor  sermones  complectentes.  Per 
Janum  Cornarium  Latine  conscripti.  In  the  collection  of  Stephanus. 
Venice,  1567. 


DISCOUKSE.  195 

eration ;  the  fifteenth  also  treats  of  diseases  mostly 
surgical,  tumors,  ganglia,  strumous  affections,  aneur- 
isms; and  enters  fully  into  the  preparation  and 
employment  of  plasters.  The  last  discourse  of  all 
is  occupied  with  diseases  peculiar  to  women.  The 
portions  of  the  work  assigned  to  the  management 
of  young  children,  are  full,  and  well  considered,  as  are 
also  those  on  fevers.  The  following  observations  on 
eruptive  fevers,  which  he  derives  from  Herodotus,  a 
practitioner  at  Kome  prior  to  the  time  of  Galen,  are 
worthy  of  notice  : — - 

In  certain  acute  fevers,  says  he,  there  will  be  an 
eruption  of  pustules  about  the  lips  and  nose  towards 
the  close  of  the  attack.  In  fevers  which  are  not 
simple,  but  rather  from  a  depraved  condition  of  the 
humors,  there  will  appear  vibices  like  flea-bites,  over 
every  part  of  the  body.  In  malignant  and  pestilential 
fevers,  these  may  ulcerate  and  sometimes  assume  the 
appearance  of  carbuncles  [a  term  here  applied  to 
minute  and  highly  inflamed  pustules,  and  to  furun- 
cles, as  well  as  to  what  is  now  understood  by  car- 
buncle]. These  eruptions  are  all  indicative  of  a 
multitude  of  corrupt  and  erosive  humors.  Those 
which  appear  on  the  face  are  the  most  malignant ; 
their  danger  being  in  proportion  to  their  num- 
ber and  dimensions.  Those  which  rapidly  dis- 
appear, or  go  through  their  changes  quickly,  are 
worse  than  those  of  longer  duration.  The  highly 
inflamed  are  more  dangerous  than  such  as  are  at- 
tended with  pruritus.  Those  following  constipation 
or  moderate  evacuation,  are  of  little  danger;  but 
those  succeeding  a  looseness  or  vomiting  are  bad. 


196  DISCOURSE. 

Pustules  are  often  followed  by  malignant  fevers,  or 
by  deliquium  animi.* 

The  allusions  in  the  foregoing  paragraph  will  be 
seen  to  have  some  bearing  upon  the  eruption  and 
fever  of  small  pox  ;  and  their  bearing  upon  this  dis- 
ease will  be  more  clearly  seen  by  comparing  them 
with  a  similar  passage  hereafter  to  be  introduced 
from  Ahrun,  the  earliest  author  known  to  have 
written  expressly  upon  that  disease. 

Many  surgical  topics  are  well  handled  by  Aetius. 
He  was  a  strenuous  advocate  for  the  actual  cau- 
tery. He  is  the  first  to  mention  uterine  calculus- 
He  recommends  the  perineal  operation  for  vesical 
calculus;  and  describes  a  scabrous  affection  of  the 
bladder,  which,  however,  is  also  spoken  of  by  Ori- 
basius.  He  excises  hsemorrhoidal  tumors ;  he  oper- 
ates on  brachial  aneurism  by  a  double  ligature  upon 
the  artery  on  the  cardiac  side  of  the  tumor,  and 
subsequently  opening  the  sac  and  emptying  it ;  and 
secures  the  vessel  at  the  points  of  its  communication 
with  the  tumor.  But  he  pays  his  deference  to  the 
superstition  of  his  times,  in  recommending  the  use  of 
amulets,  and  in  resorting  to  charms  and  incantations. 
For  removing  a  foreign  substance  from  the  pharynx, 
he  tells  us  to  touch  the  patient's  neck  and  repeat  the 
following:  "As  Jesus  Christ  raised  Lazarus  from 
the  dead,  and  Jonas  from  the  whale's  belly,  so  do 
thou,  whether  shell  or  bone,  make  thy  escape ;"  or 
thus:  "The  martyr  St.  Blaisius  and  the  Saviour 
Jesus  Christ,  command  thee  to  move  either  upwards 

*  Tetr.  ii.  serm.  i.  cap.  cxxix. 


DISCOURSE.  197 

or  downwards."  In  like  manner  he  resorts  to  incan- 
tations and  Scriptural  expressions  in  the  preparation 
of  his  medicaments,  for  imparting  to  them  greater 
efficacy.  In  compiling  from  other  writers,  Aetius  is 
careful  to  give  the  name  of  the  author  at  the  head  of 
each  chapter.  He  has  thus  preserved  the  names  and 
given  valuable  extracts  from  the  works  of  several 
writers  not  elsewhere  mentioned  ;  among  these  may 
be  noticed  Aspasia,  an  able  and  original  writer  on 
obstetrics  and  the  diseases  of  women  and  children, 
from  whom  many  distinct  chapters  have  been  bor- 
rowed by  him,  and  in  this  way  preserved  from 
oblivion. 

Alexander,  surnamed  Trallianus,  from  his  native 
city,  Tralles  in  Lydia,  flourished  shortly  after  Aetius, 
whom  he  takes  occasion  to  mention.  He  was  of  a 
talented  family ;  his  father  Stephen,  and  his  brother 
Dioscurus,  were  of  his  own  profession ;  his  brother 
Olympius,  was  distinguished  in  jurisprudence;  his 
brother  Metrodorfts  was  known  as  a  grammarian  ; 
and  a  fourth,  Anthemias,  was  employed  as  an  archi- 
tect by  Justinian,  A.  D.  532,  in  building  the  cathe- 
dral of  St.  Sophia,  which  still  stands  among  the 
principal  ornaments  of  Constantinople.  Alexander 
had  traveled  extensively  in  Italy,  Gaul,  and  Spain, 
and  had  resided  long  in  Tuscany,  before  ultimately 
settling  in  Rome,  where  he  rose  to  great  distinction. 
His  work  on  the  art  of  medicine,^  dedicated  to  his 
friend  Cosmas,  the  son  of  his  preceptor,  was  written 


*  Alexandri  Tralliani  de  Arte  Medica  libri  duodecim,    Joanne  Guin- 
terio  Andernaco  interprete.     See  Collection  of  Stephanus,  Venice,  156Y. 


198  DISCOURSE. 

after  the  infirmities  of  age  had  disabled  him  from 
the  more  active  duties  of  the  profession.  This  work 
is  worthy  of  notice  no  less  for  the  discriminating 
judgment  and  original  observations  of  its  author, 
than  for  the  order  and  perspicuity  of  his  descrip- 
tions of  disease,  or  for  the  simplicity,  force,  and  ele- 
gance of  his  style.  In  point  of  originality,  Alexan- 
der ranks  next  after  Hippocrates  and  Aret^us.  He 
speaks  of  Galen  in  higher  terms  than  any  previous 
writer,  calling  him  the  "  most  divine,"  and  placing 
him  even  above  Hippocrates.  Nevertheless,  he  does 
not  hesitate  to  dispute  the  authority  of  this  great 
master  when  at  variance  with  his  own  experience. 
His  work  consists  of  twelve  books ;  of  which,  in 
their  present  numerical  order,  the  first  eleven  treat 
of  diseases,  from  the  head  downwards.  The  last  is 
mostly  occupied  with  fevers.  •  But  the  dedication 
or  introduction  to  the  w^hole  work,  is  at  the  opening 
chapter  of  this  twelfth  book ;  where  the  author 
speaks  as  if  at  the  commencenient  of  his  literary 
labors.  It  is,  therefore,  reasonable  to  infer  that  the 
twelfth  book,  as  at  present  arranged,  must  have 
been  originally  the  first ;  and  that  it  was  the  author's 
object  to  speak  of  constitutional  or  general  ailments 
first,  and  of  local  diseases  afterwards.  The  work  is 
occupied  almost  exclusively  with  the  description 
and  treatment  of  diseases  ;  with  little  allusion  to  an- 
atomy, to  topics  strictly  surgical,  or  even  to  the 
materia  medica,  except  in  direct  relation  of  remedies 
to  the  diseases  in  which  they  are  employed.  Under 
the  head  of  each  ailment,  he  lays  down  the  charac- 
teristic appearances  and  symptoms ;  points  out  the 


DISCOURSE.  199 

divisions  and  subdivisions ;  notes  tlie  diagnostic 
symptoms  when  necessary ;  enters  occasionally  into 
tlie  exciting  causes  and  the  actual  conditions  of  dis- 
ease, in  accordance  with  the  humoral  pathology  of 
Galen,  or  sometimes  with  the  theory  of  the  metho- 
dists ;  and  finally  proceeds  to  the  treatment,  whether 
by  diet  and  regimen,  or  the  administration  of  medi- 
cines. In  the  management  of  acute  diseases,  he  jfays 
great  attention  to  the  influence  of  age,  tempera- 
ment, mode  of  life,  atmospheric  changes,  season  of 
the  year,  and  above  all  to  the  effects  of  nature. 
He  enjoins  caution  in  the  use  of  opium  for  the  cure 
of  diarrhcea,  in  consequence  of  its  severe  effects  upon 
the  brain.  He  is  opposed  to  the  use  of  astringents 
in  dysentery,  which  he  treats  in  accordance  with  the 
rational  indications.  His  favorite  remedy  for  dropsy 
was  venesection,  which  he  adopted  from  having  seen 
oedema  in  a  limb,  where  the  movement  of  the  blood 
through  the  part  had  been  arrested  by  tight  pres- 
sure above  the  tumefied  portion,  entirely  overcome 
by  removing  the  pressure.  In  chronic  ailments  he 
preferred  mild  aperients  to  drastic  purgatives.  He 
has  been  often  commended  for  his  skill  in  dias^nosis. 
The  passage  usually  referred  to  in  proof  of  this,  is 
that  in  which  he  lays  down  the  distinctive  signs  of 
pleurisy  and  inflammation  of  the  liver ;  a  passage 
which  the  modern  pathologist  would  hardly  select 
for  the  purpose ;  and  in  which,  from  what  is  stated, 
he  appears  to  have  confounded  pleurisy  with  inflam- 
mation of  the  lung.  Like  Aetius  and  Marcellus, 
this  author  also  recognizes  the  use  of  charms  and 
amulets.     But  on  the  whole,  considering  the  age  in 


200  DISCOURSE. 

whicli  lie  lived,  lie  was  of  sound  judgment  and  great 
practical  ability;  and  the  work  whicli  lie  has  be- 
queathed to  us  is  among  the  most  valuable  relics  of 
ancient  medicine. 

The  reign  of  Justinian,  from  A.  D.  527  to  A.  D. 
565,  was  one  of  much  vigor,  and  marked  by  success 
against  the  overwhelming  inroads  of  barbarism.  By 
th^  prowess  of  his  generals,  Belisarius  and  Narses, 
Italy  was  for  a  season  delivered  from  the  Goths,  and 
the  two  portions  of  the  empire  again  united.  Under 
the  supervision  of  his  able  minister,  Tribonian,  the 
whole  body  of  Koman  law  was  revised  and  reduced 
to  system.  The  schools  of  Constantinople  were  ris- 
ing into  notice,  and  were  under  the  supervision  of 
able  men."^ 

The  sophist  and  historian  Procopius,  who  flour- 
ished in  this  reign,  if  not  educated  for  the  practice 
of  medicine,  was  well  versed  in  every  thing  pertain- 
ing to  the  science,  and  is  worthy  of  notice  for  his 
admirable  description  of  the  plague,  which  began  in 
Egypt,  A.  D.  542,  extended  thence  through  Pales- 
tine, reached  the  Eastern  capital  in  the  year  follow- 
ing ;  and  spreading  throughout  every  portion  of  the 
empire,  continued  its  ravages  for  more  than  fifty 
years.  The  disease  was  in  every  respect  identical 
with  the  modern  plague  of  the  Levant.  The  ac- 
count of  its  first  appearance  at  Constantinople,  by 
Procopius,  is  worthy  of  special  notice  for  his  allusion 
to  human  dissections.f    The  physicians,  he  tells  us, 

*  Gibbon. 

f  Freind,  History  of  Physic  from  the  time  of  Galen  to  the  be^nning  of 
the  sixteenth  century.     2  vols.  8vo.     London,  1726.     Vol.  i.  p.  149, 


DISCOURSE.  201 

conceiving  the  venom  and  head  of  the  disorder  to 
be  in  the  plague-sores,  opened  the  dead  bodies,  and, 
searching  the  sores,  found  huge  carbuncles  grow- 
ing inward.      Procopius  has  supplied  much  other 
interesting  information  in  reference  to  the  practice 
of  medicine  and  the  physicians  of  his  time.   Elpidius, 
archiater  to  Theodoric,  he  tells  us,  was  the  person 
to  whom  that  monarch  confessed  his  regret  at  hav- 
ing taken  the  lives  of  Symmachus  and  Boetius.     He 
states,  that  during  the  siege  of  Edessa,  Stephen,  a 
physician  of  that  city,  who  had  formerly  been  pre- 
ceptor of  Chosroes,  and  medical  attendant  upon  his 
father,  was  chosen  to  conduct  an  embassy  to  Persia. 
And  that  Chosroes,  before  accepting  the  proposals  of 
Justinian  for  peace,  demanded  as  one  of  the  con- 
ditions, that  the  physician  Tribunus  should  be  sent 
to  him.     Tribunus  was  accordingly  sent,  and  after 
curiug  the  king  and  residing  a  year  in  Persia,  was 
permitted  to  depart  with  such  rewards  as  he  should 
ask.     But,  instead  of  wealth  or  honors,  he  requested 
that  certain  of  his  fellow  countrymen,  then  captives 
amoDg  the  Persians,  might  be    set   at   liberty ;    a 
request  with  which  Chosroes  complied,  by  releasing 
not  only  the  individuals  specified,  but  others  to  the 
number  of  three  thousand.    The  Greek  physicians  of 
this  age,  however,  were  not  all  so  worthy  of  their 
calling.     One  of  them,  Uranus,  like  Thessalus  in  the 
time  of  Nero,  supplied  by  self-assurance  the  defects 
of  education,  and  the  absence  of  real  merit.     Having 
accompanied  the  embassy  from  Edessa,  he  imposed 
himself  upon  Chosroes  as  a  philosoj^her,  confronted 
the  Persian  Magi  in  questions  of  science ;  and  after 
14 


202  DISCOURSE. 

his  return,  was  honored  by  the  personal  correspon- 
dence of  the  Persian  king. 

The  institutions  of  Christianity  under  the  autho- 
rity of  Justinian,  were  still  more  firmly  strengthened 
than  formerly.  The  ancient  schools  of  philosophy 
at  Athens,  were  by  his  imperial  edict  finally  closed, 
and  their  property,  with  that  of  the  other  remaining 
institutions  of  paganism,  appropriated  to  the  build- 
ing of  churches.  But  the  expulsion  of  the  philosophers 
from  their  ancient  home  amid  the  groves  of  Acade- 
mus,  cast  a  cloud  upon  his  name.  Exiled  for  refusing 
to  adopt  the  Christian  faith,  Damascius  of  Syria,  Sim- 
plicius  of  Cilicia,  Eulalius  of  Phrygia,  Priscianus 
of  Lydia,  Diogenes  and  Hermias  of  Phenicia,  and 
Isidore  of  Gaza,  forsaking  the  Academy,  turned  their 
faces  towards  the  East.  They  accepted  the  hospitality 
of  Chosroes,  enjoyed  under  the  protection  of  this  saga- 
cious prince,  that  freedom  from  persecution  to  which 
they  had  been  strangers  in  their  own  land,  and  in 
the  exercise  of  their  talents  became  the  founders  of 
new  schools  for  the  difi*usion  of  Grecian  science  and 
civilization  beyond  the  limits  of  the  empire.* 

From  the  reign  of  Justinian  to  the  downfall  of 
Alexandria,  the  only  writers  on  medicine  worthy  of 
notice,  were  Theophilus,  Stephen  of  Athens,  John  of 
Alexandria,  Palladius,  Ahrun,  and  Paulus  ^gineta. 
The  first  of  these,  Theophilus,  called  also  Philaretus, 
was  a  monk,  and  officiated  as  physician  at  the  court 
of  Ileraclius,  who  reigned  from  A.  D.  610  till  641. 
He  was  the  author  of  a  treatise  on  the  structure  of 

*  Freind,  vol.  i.  p.  133;  Sprengel,  tome  ii.  p.  192;  Gibbon. 


DISCOURSE.  203 

the  human  body  considered  in  a  theological  point  of 
view,  after  the  manner  of  Galen's  treatise  De  Usu 
Partium ;  drawing  his  materials  from  Ruffus  and 
^^  Galen,  with  occasional  additions  of  his  own.  He 
also  left  a  treatise  on  the  Pulse,  and  another  on  the 
Urine.  This  latter,  though  of  little  originality,  may 
be  considered  the  first  of  a  series  of  works  on  the 
same  subject,  mostly  by  the  Urinoscopists  of  the 
middle  ages,  who,  as  may  be  seen  in  the  Lilium 
Medicinse  of  Bernard  Gordon,  carried  their  chican- 
ery to  a  pitch  of  absurdity  perhaps  never  equaled 
by  any  other  class  of  medical  industrialists. 

Stephen  of  Athens,  John  of  Alexandria,  and  Pal- 
ladius,  were  commentators  on  Hippocrates ;  and  with 
Ahrun  and  Paulus  ^gineta,  were  all  of  the  Alex- 
andrian school.  Palladius,  the  latrosophist,  was  also 
the  author  of  a  work  on  Fevers,  in  which  he  advo- 
cated theoretical  views  proper  to  himself,  though 
based  upon  the  humoralism  of  his  predecessors.* 

Ahrun,  a  priest  and  physician  of  Alexandria  who 
flourished  duriog  the  reign  of  Heraclius,  was  the 
first  to  write  on  small-pox  and  other  kindred 
eruptive  fevers.  His  thirty  books  of  Pandects  are 
no  longer  extant,  though  extracts  from  them  have 
been  preserved  by  Rhazes  and  Haly  Abbas. 

*•  Pestilential  ulcers,"  says  he,  speaking  of  plague, 
''  are  hot  abscesses  which  appear  at  the  groin 
and  arm-pit,  and  prove  fatal  in  four  or  five 
days.  Those  which  are  black  are  malignant  : 
the    red    are    sometimes    fatal ;    but    when    they 

*  Sprengel,  tome  ii.  p.  221-2. 


204  DISCOURSE. 

are  black  or  green,  tTie  patient  hardly  ever  re- 
covers. And  so  also,  with  the  measles  and  small- 
pox, and  other  eruptive  diseases  :  those  that  are 
black  or  green  are  the  most  malignant ;  the  yellow 
are  also  dangerous,  but  not  so  much  so  as  those  just 
mentioned ;  while  those  that  are  red  or  white  are 
the  most  curable."  "  The  small-pox,  boils,  and  the 
like,"  says  he,  "  all  arise  from  blood  that  is  corrupt 
and  adust  with  yellow  bile."  Again  :  "  When  you 
know  that  the  small-pox  is  beginning  to  break 
out,  do  not  give  the  patient  cold  medicine,  which 
would  tend  to  keep  back  the  pustules  in  the 
interior ;  but  let  him  have  sweet  fennel  and 
smallage  in  order  to  bring  them  to  the  surface  ; 
and  let  him  rinse  his  mouth  with  a  decoction  of 
lentils  and  sumach,  in  order  that  none  may  come 
out  on  his  mouth  and  throat,  and  hurt  them."* 

Paulus  JEgineta  was  educated  at  Alexandria,  and 
is  supposed  to  have  been  a  professor  in  that  city,  at 
or  about  the  period  of  its  final  subjugation  by  the 
Saracens,  A.  D.  640.  His  workf  presents  an  able 
and  orderly  summary  of  Greek  medicine  from  Hip- 
pocrates onward.  He  claims  merely  to  have 
abridged  it  from  Oribasius,  with  the  view  of  furnish- 


*  Greenhill's  translation  of  Rhazes  on  the  Small-Pox  and  Measles.  8vo. 
London,  1848,  pp.  103,  129,  163. 

f  Pauli  ^ginetse  Totius  Rei  Medicse  libri  vii.,  per  J.  Cornarium,  fol. 
Basil,  1556.  A  previous  version  called  Opus  Divinum,  published  at  the 
same  place,  1532,  wants  the  sixth  book.  See  also,  the  Artis  Medicinse  Prin- 
cipe->,  collection  of  Stephanus,  1567,  which  gives  Cornaro's  version.  Also, 
the  Eiiglish  Translation  bj  F.  Adams,  3  vol?.  Svo.  London,  1844.  And  the 
French  version  of  the  sixth  book,  entitled  "  Chirurgie  de  Paul  d'Egine,"  par 
Rene  Brian.     8vo.  Paris,  1855. 


DISCOURSE.  205 

ing  an  epitome  of  medical  science  less  voluminous 
than  the  cyclopediac  compilations  of  that  writer, 
and  more  useful  to  the  physician  than  the  imperfect 
synopsis  which  Oribasius  had  left  of  his  own  collec- 
tions. But  in  the  execution  of  this  task,  Paulus  ex- 
ceeds his  original  intention.  He  draws  from  many 
sources,  and  much  from  his  own  experience  ;  and  in 
all  that  relates  to  surgery,  he  is  more  full  and  circum- 
stantial than  any  other  of  the  ancient  authors,  not 
even  excepting  Celsus.  His  work  is  divided  into 
seven  books.  In  the  first,  he  treats  of  hygiene  and 
the  rules  of  health,  as  applied  to  different  ages,  sea- 
sons, temperaments,  and  to  the  use  of  different 
articles  of  diet.  In  the  second,  he  treats  of  fevers, 
excrementitious  discharges,  critical  days,  complicat- 
ing symptoms  and  appearances.  In  the  third,  of 
local  affections,  from  head  to  foot.  In  the  fourth,  of 
external  maladies  limited  to  no  particular  part  of 
the  surface,  including  cutaneous  and  verminous  dis- 
eases. In  book  fifth,  he  treats  of  wounds  and  the 
bites  of  venomous  animals,  of  poisons  and  their  anti- 
dotes. In  book  sixth,  he  describes  all  the  diseases 
calling  for  surgical  manipulations ;  and  in  the  last, 
he  treats  on  the  properties  of  medicines  simple  as 
well  as  compound,  and  particularly  of  such  as  he  had 
mentioned  in  the  former  portions  of  his  work ;  also 
on  the  modes  of  preparing  these  medicines,  and  on 
such  articles  as  may  be  substituted  for  one  another. 
Paulus  is  also  said  to  have  written  on  the  diseases 
peculiar  to  women  ;  and  for  his  skill  in  this  depart- 
ment, he  was  sometimes  called  by  the  Arabians,  Paul 
the   Obstetrician.     By   the  moderns   he   is  chiefly 


206  DISCOURSE. 

esteemed  for  his  able  exposition  of  surgical  diseases 
and  operations.  He  had  the  honor  of  being  almost 
wholly  appropriated  by  Fabricius  ab  Aquapendente, 
one  of  the  ablest  sursrical  writers  after  the  first  re- 
vival  of  learning  in  Italy.  Paulus  is  the  first  to 
speak  of  rhubarb  as  a  cathartic. 

The  only  other  writer  among  the  Greeks^  after 
the  time  of  Paulus,  and  worthy  of  rank  among  the 
ancient  classics  of  the  profession,  is  Actuarius.  He 
flourished  at  Constantinople  long  after  the  fall  of 
Alexandria ;  and  is,  therefore,  to  be  reckoned  among 
the  luminaries  of  the  middle  ages. 


Before  closino'  this  hurried  sketch  of  the  medical 
writers  of  antiquity,  it  is  worthy  of  remark  that  Ga- 
len, whose  authority  was  paramount  to  all  others, 
from  the  close  of  the  second  to  the  middle  of  the 
seventeenth  century,  occupies  the  middle  space  in 
the  thousand  years  which  intervened  between  the 
founding  of  the  Alexandrian  school,  and  its  ultimate 
overthrow  by  the  Saracens.  It  has  been  customary 
to  speak  of  the  deterioration  of  medical  science  dur- 
ing the  latter  half  of  this  period.  But  the  decline 
must  be  taken  in  connection  with  the  retrograde 
movement  of  general  civilization  during  the  same 
period,  and  attributed  to  the  same  causes.  With 
the  progressive  decay  of  the  Roman  empire  both  of 
the  East  and  AVest,  the  different  communities  of 
which  it  was  composed  were  gradually  sinking 
deeper  and  deeper  into  barbarism  ;  .  and  it  is  not 


DISCOURSE.  207 

wonderful  that  the  medical  profession  should  have 
.felt  the  general  influence.  Yet,  when  we  consult 
such  writers  of  this  period  as  have  reached  us,  and 
compare  those  of  the  first  with  those  of  the  second 
part  of  it,  as  Cassius,  Celsus,  Aretseus,  Dioscorides, 
Ruffus  and  Cselius  Aurelianus,  all  prior  to  the  time  of 
Galen  ;  with  Oribasius  of  the  fourth  century,  Aetius 
and  Trallianus  of  the  sixth,  and  finally,  with  Paulus 
^gineta,  the  last  and  among  the  best  of  them  ;  we 
are  struck  with  the  general  uniformity  of  their  views 
and  modes  of  reasoning,  as  well  as  with  their  course 
of  practice.  There  is  nearly  as  much  originality,  if 
not  as  much  acumen,  in  proportion  to  their  number, 
in  the  one  group  as  in  the  other.  Paulus  and  Tral- 
lianus in  this  respect,  are  the  ablest  ofisets  against 
Celsus  and  Aretseus.  Of  the  later  group,  with  the 
two  exceptions  just  mentioned,  few  ventured  much 
beyond  the  business  of  commentators  or  compilers. 
But  in  this  they  were  not  corrupters  of  the  art. 
With  the  earlier  masters  still  before  them,  they  have 
*advanced  opinions  of  their  own  sufiScient  to  show 
that  if  medicine  had  not  been  revolutionized  by 
them,  it  had  never  been  entirely  neglected.  The 
principles  and  practices  established  in  better  times 
were  still  maintained.  The  profession  of  those  days, 
conscious  of  their  own  position,  were  content  to 
reverence  what  they,  had  neither  the  skill  to  equal, 
nor  the  temerity  to  set  aside. 


208  DISCOURSE 


CHAPTER     XIII. 


LAWS  AND  CUSTOMS  OF    THE    ROMAN   EMPIRE   IN   RELA- 
TION  TO    THE    PROFESSION. 

Prior  to  the  consolidation  of  the  empire,  there 
were  probably  no  well-established  laws  among  the 
Pomans  in  regard  to  medical  education,  the  term  of 
study,  or  the  qualifications  of  physicians.  The 
system  of  training  previously  in  use  among  the 
Greeks,  appears  in  course  of  time  to  have  been  uni- 
versally adopted.  The  liberally  educated,  whether 
of  the  profession  or  not,  were  all  more  or  less  initi- 
ated in  what  was  then  the  philosophy  of  medicine ; 
and  some  of  the  uses  to  which  such  information  was 
applied  by  them,  may  be  learnt  from  Varro  in  his 
directions  for  the  building  of  villas  ;*  or  from  Vitru-. 
vius,f  a  writer  of  the  Augustan  era,  whose  au- 
thority in  all  that  relates  to  the  locality  of  dwel- 
lings, to  public  works,  and  to  the  planning  of  new 
cities,  might  with  advantage  be  consulted  in  ques- 
tions of  hygiene  as  applied  to  architecture,  at  the 
present  day.  The  hygienic  arrangements  in  the 
rural  economy  of  Palladius,  must  also  have  been  de- 
rived from  the  same  source. J 


*  M.  Terentii  Varronis  De  Re  Rustica  lib.  i.  cap.  xi.  and  xii. 

f  Marei  Vitruvii  Pollionis  De  Arcbitectura  libri  decern.  Lipsiae,  1836. 

J  Palladii  Rutilii  De  Re  Rustica  lib.  i. 


DISCOTJRSE.  209 

The  well-educated  physician,  in  common  with 
his  medical  knowledge,  was  presumed  to  be 
familiar  with  the  grammatical  structure  of  his 
own  language,  with  rhetoric,  arithmetic,  geometr.y 
dialectics,  moral  philosophy,  astronomy,  and  even 
architecture.  Galen  refers  to  these  several  branches 
of  general  education,  as  proper  means  for  sharp- 
ening the  intellect  of  the  student  preparatory 
to  assuming  the  difficult  and  responsible  duties 
of  the  profession."^  And  his  contemporary,  Apu- 
leius  Madaurensis,  who  styles  himself  the  "  not 
unknown  priest  nor  recent  worshiper,  nor  un- 
favored minister,  of  ^^culapius,"  addressing  the 
people  of  Carthage  in  his  figurative  manner,  says 
of  the  Goblet  of  the  Muses,  '^The  oftener  it  is 
drained  and  the  more  unmixed  it  is,  the  more  it  con- 
duces to  soundness  of  mind.  The  first  cup,  that  of 
the  reading-master,  takes  away  ignorance ;  the 
second,  of  the  grammarian,  instructs  in  science ;  the 
third,  the  rhetorician's,  arms  with  eloquence.  Thus 
far  most  people  drink.  But  I  have  drunk  other 
cups  at  Athens,  the  cup  of  poetry,  the  inventive ; 
of  geometry,  the  limpid ;  of  music,  the  sweet ;  of 
dialectics,  the  roughish ;  and  of  universal  philoso- 
phy, the  never-satiating  nectarious  cup."  f 

The  time  usually  devoted  to  the  study  of  med- 
icine, beyond  that  spent  in  the  literary  course,  as  may 
be  inferred  from  Galen  and  others,  was  not  short  of 


*  De  Cognoscendis  Curandisque  Animi  Morbis  lib.  viii.  cap.  1.  Kuhn's 
edition,  vol.  v.  p.  42.  See  also  Admiaistrationes  Anatomicae,  lib.  i.  c.  ii. 
Kuhn's  edition,  vol.  ii.  and  numerous  other  parts  of  bis  writings. 

f  Florida,  chap,  xx 


210  DISCOURSE. 

five  years.  Galen,  after  a  philosophical  course  of 
three  years,  which  he  began  at  the  age  of  fourteen, 
had  already  been  a  student  of  medicine  under  Sa- 
tyrius  four  years,  at  the  breaking  out  of  the  plague 
in  Pergamus,  most  of  the  time  in  daily  attendance 
upon  the  sick  within  the  temple.  On  the  subsidence 
of  the  epidemic  of  that  city,  he  resorted  to  Smyrna ; 
there  to  continue  his  course  under  Pelops ;  he  after- 
wards became  the  pupil  and  assistant  of  Kumisianus, 
at  Corinth  ;  spent  some  time  in  Alexandria  and 
other  cities,  and  after  finishing  his  education  and  his 
travels,  he  returned  at  the  age  of  twenty-eight  to 
Pergamus,  to  practice  on  his  own  account.  Again, 
Caesarius,  brother  of  Gregory  Nazianzen,  who,  for  a 
time,  practiced  at  the  court  of  Julian,  and  was  the 
physician  and  familiar  friend  of  Valens  and  Yalen- 
tinian,  had  been  a  student  of  medicine  at  Alex- 
andria five  years;  and  may  have  been  previously 
engaged  in  the  same  pursuit  at  Csesarea,  then  a  cele- 
brated seat  of  learning,  or  at  his  native  place.  The 
term  of  study  at  the  celebrated  law-school  of  Bery- 
tus,  which  was  instituted  by  Alexander  Severus, 
occupied  five  years.*  The  laws  of  Justinian  enjoin 
that  no  apprenticeship  shall  be  binding  after  the 
age  of  twenty-five  ;f  which,  for  students  of  the  lib- 
eral professions  as  well  as  of  the  industrial  arts,  was 
the  legal  limit  to  the  period  of  pupilage. 

The  system  of  instruction  in  the  Roman  schools 
was  mostly  practical.     Anatomy,  at  least  the  dissec- 


*  Gibbon,  chapter  xvii.  §  ii.    Harper's  edition,  vol.  i.  p.  34*7. 
f  Codex  Justinian i,  lib.  x,  tit.  xlix.  §1. 


DISCOURSE.  211 

tion  of  tlie  lower  animals^  was  strictly  enjoined. 
Gralen  insists  with  great  force  upon  the  necessity  of 
this  study,  and  states  that  in  his  own  youth,  he 
allowed  no  occasion  to  escape  him  for  investigating 
the  structure  of  the  human  body.  After  witnessing 
the  dissections  of  his  teachers,  he  examined  with 
care  the  dried  and  moldering  skeletons  picked  up 
among  the  tombs ;  he  inspected  the  bodies  of  men 
drowned,  and  wafted  decomposing  to  the  shore ;  he 
turned  to  some  account  the  remains  of  a  malefactor 
who  had  been  crucified  and  suspended  near  the  way- 
side, on  a  gibbet,  as  a  warning  to  evil-doers,  and  as 
food  for  birds  of  prey.  He  advises  the  pupil  to  dis- 
sect apes  and  other  animals  ;  and  where  other  means 
fail,  to  resort  to  Alexandria,  if  for  nothing  else,  to 
have  the  opportunity  there  presented  of  studying 
the  human  skeleton.  He  labors  to  convince  his 
readers  that  a  sufficient  knowledge  of  the  art  is  to 
be  acquired  only  by  years  of  observation  and  expe- 
rience.* His  own  public  course  of  teaching  at 
Rome,  as  already  shown,  was  of  this  character.  And 
such  continued  to  be  the  method  of  instruction  up 
to  the  time  of  Oribasius;  who  informs  us  that  the 
dissection  of  apes,  in  his  day,  still  constituted  a  por- 
tion of  the  pupil's  exercise  ;  an  occupation  in  which 
he  himself  had  been  engaged.f 

Books  were  not  then,  as  now,  the  main  reliance  of 
the  student.  The  works  at  his  command  were  few. 
Of  these,  the  writings  of  Hippocrates  and  his  com- 


*  Administrationes  Anatomicae,  ut  supra, 
f  Collect,  vii.  6. 


212  DISCOURSE. 

mentators  among  the  Greeks ;  of  Celsus  and  Cselius 
Aurelianus  among  the  Latins,  next  to  the  works  of 
Galen, — were  the  chief.  Portions  of  these,  when  ac- 
cessible to  him,  he  was  required  to  ponder  over,  with 
the  oral  explanations  or  written  comments  of  his 
preceptor.  The  temples  were  open  to  him,  up  to  the 
time  of  Constantine ;  after  which  he  had  the  oppor- 
tunity of  attending,  with  his  instructor,  upon  the 
sick ;  and  was  obliged  to  practice  under  him  before 
commencing  for  himself. 

Indeed,  the  importance  of  practical  training  was, 
if  possible,  more  highly  estimated  by  the  ancients 
than  the  moderns.  Even  the  charlatans  of  Kome, 
who  spurned  all  connection  with  the  liberal  arts,  and 
professed  to  qualify  their  pupils  within  the  short 
space  of  six  months,*  were  duly  impressed  with  the 
necessity  of  clinical  teaching,  and  were  in  the  habit 
of  ostentatiously  parading  through  the  streets,  fol- 
lowed by  a  retinue  of  young  men,  with  whom  they 
made  their  daily  visits  to  the  sick  ;  a  custom  to 
which  we  owe  the  sarcastic  epigram  of  Martial : 

"  Languebam  ;  sed  tu  comitatus  ad  me 
Yenisti,  centum,  Symmache,  discipulis, 
Centum  me  tetigere  manus  Aquilone  gelatse; 
Kon  habui  febrem,  Symmacbe,  nunc  habeo  !"f 

At  Rome,  as  among  the  Greeks,  there  were 
physicians  belonging  to  the  servile  races.  And,  that 
these  might  the  more  readily  practice  their  profession, 


*  Galen,  Methodus  Medendi,  lib  i.  cap.  i.    Kulin's  edition,  vtl.  x.  p.  5. 
f  Lib.  V.  Ep.  9. 


DISCOURSE.  213 

they  were  usually  declared  freedmen  by  their  mas- 
ters. The  estimation  placed  upon  slaves  engaged  in 
the  practice  of  medicine,  may  be  ascertained  from 
the  Codex  of  Justinian  ;*  which  fixes  the  legal  value 
of  a  maid  servant  at  twenty  solidi ;  of  a  male  slave 
skilled  in  any  handicraft,  at  thirty  solidi ;  notaries, 
whether  male  or  female,  at  fifty  solidi ;  and  physi- 
cians, male  or  female,  at  sixty  solidi. 

We  have  already  seen  that  in  ancient  Egypt,  as 
far  back  as  history  extends,  the  practice  of  medi- 
cine was  divided  into  numerous  branches.  This  cus- 
tom never  became  general  among  the  Greeks  or 
Komans ;  yet  in  the  larger  cities  some  approach  was 
made  towards  it.  Galen  informs  us  that  in  the  less 
populous  districts,  where  specialists  were  unable  to 
find  employment,  they  were  in  the  habit  of  peram- 
bulating the  country,  and  practicing  from  place  to 
place.  Pharmacy,  as  already  shown,  had  become  a 
distinct  department  as  early  as  the  days  of  Aris- 
totle. Gymnasiarchs  and  latroleptists,  or  anointers 
and  bathers,  in  the  exercise  of  their  calling,  were  in 
some  measure  subservient  to  the  profession,  and  had 
always  paid  some  attention  to  the  treatment  of 
injuries.  Midwifery  was  still  in  the  hands  of  the 
obstetrix.  And  some  few  of  these  ancient  hand- 
maids of  Lucina,  as  Aspasia,  Cleopatra,  and  others, 
were  writers  as  well  as  practitioners.  But  sur- 
gery and  medicine  proper,  though  sometimes 
taught  or  practiced  separately  as  specialities,  were 


*  Lib.  vii.  tit.  vii,  §  5. 


214  DISCOURSE. 

never  disconnected  by  the  educated  physicians  of 
antiquity,  who  rejected  most  of  the  specialists  as 
impostors.*^ 

Of  these  illegitimate  sons^of  ^sculapius,  the  num- 
bers and  pretensions  were  as  great  in  ancient  as  in 
modern  times ;  and  they  were  quite  as  apt  to  re- 
ceive the  countenance  and  favor  of  the  upper 
classes.  Chosroes  of  Persia  was  the  patron  of 
Uranus  ;  and  Nero  was  the  supporter  of  the  au- 
dacious Thessalus,  who,  like  Paracelsus,  repudiated 
all  learning  as  useless,  and  like  the  still  more  recent 
mountebank,  Hahnemann,  modestly  assumed  to  be 
above  all,  and  opposed  to  all,  who  had  ever  gone 
before  him.  Pliny  and  Galen  are  justly  severe  on 
most  of  these  ancient  impostors.  And  if  we  can 
credit  their  account  of  them,  the  host  of  industrial- 
ists, oculists,  rhinoplasts,  dentists,  bone-setters,  her- 
niotomists,  lithotomists,  gelders,  abortionists,  and 
poison-vendei-s,  pervading  Italy,  France,  and  Spain 
throughout  the  middle  ages, — before  whom  the 
modern  group  of  pretenders  grow  pale  and  insig- 
nificant,— were  at  least  equaled,  if  not  exceeded,  in 
ignorance,  as  well  as  arrogance,  by  the  quacks  of 
Eome.f 

With  regard  to  schools,  besides  the  cities  already 
mentioned,  Athens,  Corinth,  Berytus,  Laodicea,  and 
Csesarea,  among  the  Greeks  ;  and  at  different  epochs, 
Milan,  Pavia,Traves,  Aries,  Marseilles,  and  Bordeaux 


*  Corpus  Juris  Civilis  Digest,  lib.  L  tit.  xiii.  §  iil 

•j-  Galen,  Methodus  Medendi,  lib.  i.,  cap.  i.,  ii.,  iii.  Vol.  x  p.  5,  et  seq, 
Pliny,  lib.  xxix,,  cap.  viii.  Corpus  Juris  Civilis  Digest,  lib.  1.,  tit.  xiii.,  1.  3. 
et  Julii  Pauli  Recept.  Sentent.  lib.  v.  tit.  xxiii.,  §§  7, 8, 11,  12. 


DISCOURSE.  215 

among  the  nations  speaking  the  Latin  tongue, — in 
short,  most  of  the  other  large  cities  of  the  empire, — 
supported  each  its  own  institution  ;  in  which  the 
study  of  medicine  was  systematically  pursued  in  con- 
nection with  other  liberal  arts  and  sciences."^  Each 
of  these  schools  enjoyed  a  degree  of  local  reputation; 
and,  with  regard  to  medicine,  held  by  custom,  if  not 
by  rescript,  somewhat  the  same  relation  to  that  of 
Alexandria,  as  the  gymnasia  and  provincial  medical 
schools  of  Prussia,  Denmark,  and  Holland  at  pres- 
ent hold,  to  the  more  celebrated  universities  of 
these  countries.f 

Though  many  of  these  institutions  may  have  been 
of  spontaneous  growth,  yet  by  degrees  most  of  them 
fell  under  the  immediate  patronage  and  supervision 
of  government.  The  number  of  professorial  chairs 
in  each  of  them  was  regulated  By  law. J  The  pro- 
fessors, in  common  with  the  Archiatri  or  state 
physicians,  received  a  fixed  salary  out  of  the  public 
treasury  ;§  and  after  a  faithful  performance  of  their 
duties  for  twenty  years  they  had  the  privilege  of 
retiring  with  honor  in  the  enjoyment  of  a  pension. | 
Teaching,  however,  was  not  wholly  restricted  to  the 
state  and  salaried  professors,  -but  was  open  to  other 
able  and  educated  men.^ 

*  Guizot,  Cours  d'Histoire  Moderne,  Legon  4m,  p.  160,  and  Legon  16m, 
p.  261. 

\  De  Medicis  et  Studio  Medicinae  iu  urbe  Alexandrina,  hoc  scitu  dig- 
num  refert,  Ammian.  [22  in  fin.] ;  ad  commendandam,  inquit,  artis  peri- 
tiam,  medico  pro  omni  experimento  sufficit  si  Alexandrise  dixerit  se  eru- 
ditum.     [Notes  to  the  Codex  Justiniani,  lib.  i.,  tit.  iii.  cap.  18.] 

jj.  Digest,  lib.  xxvii.,  tit.  i.,  cap.  vi.,  §  2. 

§  Codex  lib.  x.,  tit.  Iii.,  §  6. 

I  Lib.  xii.,  tit.  xv. 

T[  Digest,  lib.  xxvii.,  tit.  i.  cap.  vi.,  §  11. 


216  DISCOURSE. 

The  attention  bestowed  upon  the  schools  by- 
some  of  the  emperors  after  the  time  of  Constantine, 
appears  to  have  been  extremely  inquisitorial*  The 
edict  of  Valentinian,  Valens,  and  Gratian,  addressed 
to  Olybius,  the  prefect  of  Eome,  A.  D.  3Y0,  though 
probably  intended  solely  for  the  advancement  of 
learniug,  is  sufficient  to  show  the  jealous  care  with 
which  the  government  officials  watched  over  all  men 
of  liberal  education  ;  and  that  real  liberty,  even  in 
the  pursuit  of  knowledge,  had  long  since  given 
place  to  arbitrary  power. 

In  compliance  with  this  edict,  the  youth  coming 
to  Rome  for  completing  their  literary  education, 
were  required  to  furnish  the  city  magistrate  with  a 
passport  from  the  governors  of  their  respective 
provinces,  stating  their  name,  age,  and  rank  in  life  ; 
to  declare,  on  arrival,  the  course  of  studies  to  which 
they  intended  to  devote  themselves ;  and  to  acquaint 
the  magistrate  with  their  place  of  abode  in  the 
city,  in  order  that  he  might  place  them  under  mas- 
sters  in  charge  of  such  branches  of  education  as 
they  had  selected.  They  were  held  under  the 
most  rigid  supervision  by  the  city  authorities,  with 
reference  to  their  conduct  in  the  public  assemblies 
of  students,  but  more  particularly  in  their  private 
associations  or  clubs ;  which  were  discountenanced 
as  vicious,  if  not  dangerous  to  the  state.  They 
were  prohibited  from  frequent  attendance  upon 
the  public  spectacles,  and  from  riotous  feasting  at 
irregular  hours.  The  student  conducting  himself 
unbecomingly,  was  subject  to  be  publicly  scourged, 

*  Codex,  lib.  x.,  tit  lii.  §§  1  and  8. 


DISCOUESE.  217 

expelled  from  the  city,  or  sent  Lome  to  Ms  own 
province.  Those  who  devoted  themselves  assidu- 
ously to  their  studies,  were  allowed  to  remain  to 
the  close  of  their  twentieth  year  ;  after  which,  fail- 
ing to  return  home,  the  magistrate  was  instructed 
to  force  them  to  do  so.  That  these  injunctions 
might  not  be  disregarded,  he  was  also  required  to 
prepare  a  monthly  statement  of  the  condition  of 
each  student ;  who  he  was,  and  whence  he  came  ; 
to  be  transmitted  at  the  close  of  the  student's  course 
of  education,  to  the  province  to  which  he  belonged. 
A  similar  table  was  also  to  be  furnished  annually  to 
the  central  bureau  of  the  government,  in  order  that 
the  emperor  might  select  from  among  those  who 
had  completed  their  education,  such  as  might  be 
wanted  for  the  public  service.^' 

By  an  edict  of  Alexander  Severus,  who  reigned 
from  A.  D.  222  to  235,  students  in  attendance  upon 
schools  not  of  their  own  municipality,  as  well  as 
their  parents  who  accompanied  them,  were  to  be 
considered  as  temporary  residents  without  the 
privileges  of  citizens,  unless  remaining  at  the  seat  of 
the  literary  institution  beyond  the  term  of  ten 
years.f 

We  have  already  seen  that  princes,  the  populous 
cities,  and  the  thickly-settled  districts  of  Greece, 
were  in  the  habit  of  stipulating  annually  for  the 
public  services  of  physicians.  This  custom  was  in 
course  of  time,  under  certain  modifications,  adopted 


*  Guizot,  legon  4m,  p.  166,  from  Cod.  Theod.,  1.  xiv.,  t.  ix.,  1.  1. 
f  Codex,  lib.  x.,  tit.  xxix.,  §  2. 

15 


218  DISCOURSE. 

by  tlie  Romans,  and  established  by  law  throughout 
the  empire.  By  a  decree  of  Antoninus  Pius,*  the 
number  of  Archiatri,  or  state  physicians,  was 
limited  in  the  metropolitan  cities  to  ten ;  in  cities 
of  the  second  class,  or  those  provided  with  a  forum 
or  hall  of  justice,  to  seven  ;  and  in  the  smaller  cities, 
to  five.  At  Rome  their  number  was  equal  to  the 
wards  of  the  city.f  They  were  chosen  by  the 
people  of  the  municipalities^  in  which  they  offici- 
ated, and  they  ranked  among  themselves  according 
to  seniority  of  appointment.§  By  an  edict  of 
Severus,  they  drew  their  salary  from  the  public 
treasury  of  their  respective  municipalities;!  and  in 
return  for  this,  they  were  required  to  attend  dili- 
gently to  the  business  of  education,  and  to  pre- 
scribe for  the  poor  gratuitously.  But  such  citizens 
as  were  able  to  pay  for  their  services,  and  stipulated 
to  do  so,  could  be  obliged  to  pay,  at  the  close  of  the 
attendance,  provided  the  stipulation  had  not  been 
exacted  from  the  patient  while  insane,  or  under 
unreasonable  alarm.^ 

In  most  of  the  Roman  laws  relatins^  to  the  Archi- 
atri,  they  are  associated  with  the  professors  of 
rhetoric,  philosophy,  and  the  liberal  arts  ;  and  in 
common  with  these,  they  and  their  families  enjoyed 
certain  privileges  and  immunities,  not  usually  con- 
ferred on  other  citizens.     They  were  exempt  from 

*  Digest,  lib.  xxvii.,  tit.  L,  cap.  vi.,  §  2. 

f  Cod.  Theod.  lib.  xiii.,  tit.  iii.,  1.  8,,  as  cited  by  Sprengel,  voL  ii.,  p.  164. 

X  Digest,  lib.  1.,  tit.  ix.,1.  1. 

§  Codex,  lib.,  x.,  tit.  Iii.,  §  10. 

I  Digest,  lib.  1.,  tit.  ix.,  1.  4,  §  2. 

^  Codex,  lib.  x.,  tit.,  Iii.,  §  9. 


DISCOTJRSE.  219 

all  painful  and  disagreeable  employments;  their 
property  was  not  subject  to  taxation  ;  they  were  not 
required  to  provide  accommodation  for  the  soldiery 
or  officers  of  justice ;  they  could  not  be  summarily 
brought  before  a  magistrate;  and  if  insulted  or 
aggrieved,  they  enjoyed  ready  and  efficient  means  of 
redress  in  the  courts  of  law.*  Such  of  them  as 
were  engaged  in  teaching,  were  more  liberally  paid 
than  those  who  devoted  their  whole  time  to  prac- 
tice.f  The  term  of  their  election  and  appointment 
to  office,  was  limited  only  by  their  ability  or  dispo- 
sition to  perform  their  duties.  If  negligent  of 
these,  their  salary  was  withheld,  and  they  were 
subject  to  deposition  from  office. J 

In  the  larger  cities  the  Archiatri  were  associated 
together  as  a  colIege.§  They  were  intrusted  not 
only  with  the  business  of  teaching,  but  also  with 
that  of  inquiring  into  the  merits  of  all  applicants  for 
occupation  in  the  profession,  and  of  certifying  to  the 
qualifications  of  each  applicant  befoi'e  the  Decuri- 
ones  or  magistrates,  by  w^hom  the  license  was  con- 
ferred.! The  private  practitioner,  applying  for  a 
vacant  seat  among  the  Archiatri,  w^as  required  to 
have  studied  and  practiced  under  some  reputable 
member  of  their  order,  and  to  have  been  regularly 
examined  and  licensed.  And  after  having  first 
obtained  the  suffrages  of  the  public  to  the  vacant 
seat,  he  had,  by  a  decree  of  Valens  and  Valentinian, 

*  Codex,  lib  x.,  tit.,  Hi.  §  11.  Digest,  lib.  xxvii.,  tit.  i.,  cap.  vi.,  §§  1,  5, 
8,  and  tit.  xiii.  1.  1. 

f  Digest,  lib.  I,  tit.  xiii.,  §  1. 

X  Ibid.  lib.  xxvii.,  tit.  i.  cap.  vi.,  §§  4  and  6. 

§  Ibid.  §  2.  .  i  Ibid.  lib.  1.,  tit.  ix. 


220  DISCOURSE. 

still  to  undergo  a  further  ordeal,  and  receive  the 
consent  of  at  least  seven  of  tlie  members  of  the  col- 
lege before  taking  his  seat  amongst  them.* 

The  physicians  of  the  imperial  household,  and 
such  as  were  intrusted  with  the  health  of  the  chief- 
magistrate,  were  also  styled  Archiatri,f  a  title  which 
was  first  enjoyed  under  Nero,  by  Andromachus  of 
Crete,  but,  perhaps,  first  regularly  recognized  by 
Domitian.  These  court-physicians  or  Archiatri-Pa- 
latini,  durinsf  the  reio:n  of  Constantine  rose  to 
greater  dignity  than  the  Archiatri  Populares,  or 
those  of  the  municipalities.  But  they  were  occa- 
sionally willing  to  sacrifice  their  position  at  the  court, 
in  order  to  obtain  the  more  lucrative  office  of  the 
municipal  institution.  Among  the  Archiatri-Pala- 
tini  there  were  also  different  grades ;  as  counts  of 
the  first  and  of  the  second  order,  and  other  higher 
dignities.  During  the  reign  of  Julian  these  titles  of 
honor  were  created  in  great  number,  and  sought 
after  with  avidity.  Some  of  the  court  physicians 
subsequent  to  this  reign,  enjoyed  the  dignity  of  Pro- 
consul, others  that  of  Duke,  &c.  They  ranked 
among  the  principal  officers  of  State,  and  some  of 
them,  as  Oribasius  and  Csesarius,  were  on  terms  of 
intimacy  with  the  emperors. 

Army  physicians,  w^hen  absent  on  duty,  and  pri- 
vate practitioners  not  of  the  constituted  number,  if 
regularly  educated  and  licensed  by  the  magistrate, 
were  entitled  to  certain  immunities  in  common  with 
other  members  of  the  liberal  professions.  J     Receiv- 


*  Codex,  lib.  x.,  tit.  lii.,  §  10  f  Codex,  lib.  xii.  tit.  xi.  xiii. 

X  Codex,  lib.  x.  tit.  ii.  §  1,  §§  5,    6. 


DISCOURSE.  221 

ing  no  public  appointment,  they  trusted  to  individual 
patronage  for  occupation,  and  had  the  right  of 
claiming  a  fair  return  for  their  services.  Privileges 
of  the  same  kind  were  also  granted  to  the  obstetrix,* 
but  were  withheld  from  specialists,  from  medical 
evil-doers,  from  the  necromancers,  exorcists,  the 
religious  medical  enthusiasts  called  Perabolani,  and 
the  numerous  other  pretenders  who  rose  up  among 
the  people,  especially  among  the  Christian  portion  of 
them,  before  the  final  overthrow  of  the  pagan  insti- 
tutions.f 

But  if  this  new  order  of  Christian  practitioners 
received  no  favor  from  the  law,  the  spirit  that  im- 
pelled them  was  one  in  which  the  great  mass  of  the 
community  was  eagerly  participating.  Scoffed  at 
and  ridiculed  at  first,  they  were*  at  length  in  the 
ascendant ;  and  they  multiplied  in  proportion  to  the 
spread  of  Christianity.  After  Justinian  had  seques- 
trated the  salary  of  the  Pagan  teachers  for  the  pur- 
pose of  building  churches,  and  expelled  the  few 
remaining  philosophers  from  their  long  respected 
abode  in  the  Academy  of  Plato,J  these  uneducated 
practitioners  may  be  said  to  have  nearly  supplanted 
the  regularly  inducted  members  of  the  profession. 
In  the  Latin  portion  of  the  empire,  the  debasement 
of  learning  was  even  more  rapid  and  complete  than 
with  the  Greeks.  Yet  the  schools  continued  to  lin- 
ger here  long  after  the  inroad  of  the  Gothic  nations. 


*  Digest,  lib.  1.  tit.  xiii.  §  2. 

\  Corpus  Juris  Civilis.     Julii  Pauli  Recept.  Sentent.  lib.  v.  tit.  xxiii.  §  7. 
Notes  to  Digest,  lib.  1.  tit.  xiii,  §  3,  and  Codex,  lib  xii.  tit.  viii.  §  1. 
X  Novelise,  collect,  ix.  tit.  xv.  132. 


223 


DISCOUESE 


Theodoric  the  Gotli  even  attempted  the  restoration 
of  learning  in  the  West ;  and  his  successor,  Athala- 
ric,  restored  to  the  professors  at  Rome  the  salaries 
that  had  been  long  withheld  from  them.  He  also 
enriched  the  schools  of  Milan,  Pavia,  and  other  cities; 
and  Justinian  on  again  acquiring  the  dominion  of  the 
West,  confirmed  the  edict  of  the  Gothic  emperor.  ^ 
So  that  learning  may  be  said  to  have  held  some 
semblance  to  its  ancient  rank,  up  to  the  final  sub- 
jugation of  Italy  by  the  Lombards. 

But  though  the  ancient  educational  institutions, 
after  the  advent  of  Christianity  as  a  political  power, 
were  by  degrees  discountenanced  and  forsaken,  yet 
the  laws  in  regard  to  them  were  never  formally 
abrogated.  Many  of  them,  under  the  patronage  at 
first  of  the  Bishops, ^and  afterwards  of  the  Bene- 
dictine monks,  were  converted  into  Christian  schools. 
Some  of  them  in  the  Eastern  portion  of  the  empire, 
now  under  the  sway  of  the  Saracens,  served  as 
starting  points  for  the  progress  of  knowledge,  and 
especially  of  medical  knowledge,  among  the  Arabs. 
In  many  of  the  cities  and  municipalities  of  which 
the  Western  portion  of  the  empire  consisted,  and 
into  which  it  was  finally  dissolved,  traces  of  the 
ancient  system  of  medical  education  and  police  con- 
tinued visible  throughout  the  whole  of  the  middle 
ages;  and  in  connection  with  other  fragments  of 
Roman  law  not  yet  laid  aside,  played  no  unimportant 
part  in  the  early  development  of  modern  science 
and  civilization. 


*  Aliffi  Aliquot  Constitutiones  Justiniani,  capitula  xxii,  pp.  237.    Elzevir 
edition. 


E  K  E  A  T  A 


For  "Telephorus,"  page  29,  last  line  but  one,  read  Telesphorus. 
For  "  Burgess,"  page  33,  last  line,  and  page  36,  tenth  line  from  bottom, 
read  Burges. 

For  "  Clinicee,"  page  4Y,  fourth  line  from  top,  read  Clinice. 


A. 


mmr 


UNIYERSITY  OF  CALIFORNIA  LIBRARY 

Los  Angeles 

This  book  is  DUE  on  the  last  date  stamped  below. 


liomedical  Library 

MAY  27  1994 
RECEIVtD 


315 


SI 


